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    2019 NURSING ANNUAL REPORT —LEAD—INNOVATE— EXCEL— 2…………… Nursing Leadership 3…………… Nursing by the Numbers 4 & 5 ……. Nursing Leadership & Message from our Chief Nursing Officer 6 & 7……… 2019/2020 Nursing Strategic Plan 8 & 9…….. Professional Development: Growth through Learning and Opportunity & Access 10…….…… Recruiting Top Talent 11……….... Transition to Practice & Collegial Relationships 12…………. NCH School Health Nursing 13…………. NCH Physician Group— a LPN’s story & Health Services 14…………. Nursing Care Management—Population Health 15……….… System Impact by the Numbers 16…….…… Learning & Innovation 17.…….….. Advancing Healthcare 18 & 19…. Celebrating and Recognizing Excellence 20…….…… Quality Improvement & Innovation 21….……… Future of Nursing & Shared Governance 22……….... Nursing and the Community 23…………. In Memory of Diane Catalano 24 & 25… Standards of Practice & Professional Performance 26……….... President’s Message 27……….... Annual Report Credits Back Cover Friends of Nursing: The Allyn Family

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    2019 NURSING ANNUAL REPORT Nursing by the Numbers Total Number Total Number Registered Nurses Clinical Total Technicians Support Staff Number of RN Residents 1, 351 Patient Service 98 320 Representatives 196 Total Number Total Number Board Certified RNs Advanced Degrees 44 Monitor Patient Care 56 MSN Technicians 546 BSN 320 1 PhD Licensed Practical Nurses 53 2 DNP Medical Total Number Clinical Ladder Total Number Advanced Assistants Professional RNs Practice Registered Nurses 84 145 Unit 89 64 Secretaries 3

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    Our mission is to provide compassionate, safe, quality care embracing the unique needs of pa- tients and their families in our community. Nursing Leadership From left to right: Gina Teegarden, MBA, BHA, BSN, RN, Associate Chief Nursing Officer— Operations Aimee Karnes DNP, RN, Chief Nurse Informatics Officer Ilia Echevarria PhD, MS, RN, CCRN-K, NEA-BC, CNEP, CHES, Associate Chief Nursing Officer—Professional Practice Jon Kling, MBA, BSN, RN, Chief Nursing Officer NCH Healthcare System, Chief Operating Officer North Naples Hospital Erica Szczepkowski, MSN, MBA/HCM, RN, CNML, Associate Chief Nursing Officer—Operations 4 2019 NURSING ANNUAL REPORT

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    Our vision is to be the preferred destination for nursing services while providing compassionate quality care to our patients. Message from our Chief Nursing Officer When I think about the nursing vision at NCH to be the preferred destina- tion nursing services, while providing high quality, compassionate care to our patients I am honored to work for such an amazing and dedicated team of healthcare professionals. This was evident more then ever in 2019, as we saw many of our associates in the nursing department go back to school to obtain bachelor and master’s level nursing degrees and obtain certifications in their specialty. We paid out over $700,000 in tui- tion assistance and over $71,000 in scholarships to help support profes- sional growth and development. We are committed to investing in our associates to help us achieve our mission and vision. In my past letters, I highlighted our improvements related to nursing en- gagement and professional practice environment. While we are continu- ally striving to build on our improvements we are not satisfied with where we are and are committed to delivering on our vision statement for nurs- ing here at NCH. This past year we reorganized our shared governance and peer feedback processes and structure, which was led by our profes- sional practice department, and our frontline nursing leaders. This is the true definition off shared governance, and our staff engaged in the deci- sion-making process that drives our nursing practice. We have seen an increased number of new to practice RN’s (92) join our team and bring their fresh minds and passion to our already competent team. This year the ANA (American Nurses Association) has stated that this is the year of the nurse, and we are celebrating Florence Nightingales 200th birthday. While we honor her as the founder of modern nursing, the nurs- ing department at NCH will continue to focus on what makes nurses the Jon Kling, MBA, BSN, RN, most respected profession in the country and I am proud to say that at Chief Nursing Officer NCH Healthcare System NCH Nurses Care Here. NCH nursing staff from Marco Island to Bonita Chief Operating Officer North Naples Hospital Springs are committed to compassionate, high quality, patient and family centered care, while focusing on wellness and civility and compassion initiatives to help ensure NCH is THE PLACE to work at in Southwest Florida if you are a nurse or a member of our team. As I stated in the beginning of this letter, I am fortunate and extremely grateful to be able to work for all our associates to help provide world class care for the residents of Southwest Florida. 5 2019 NURSING ANNUAL REPORT

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    2019 NURSING ANNUAL REPORT 2019/2020 NURSING NCH Shared Governance supporting members collaborated with nursing leadership to formulate strategic imperatives for nursing. When developing the 2019/2020 Strategic Plan, Nursing Congress leaders discussed and re- fined our strategic initiatives. Additional feedback was gathered from nursing forums, council meetings, and feedback from individual nurses across the or- ganization. Aligning the plan to the Nursing Professional Practice model, NCH nurses are working to support the following strategic goals including: Retention • Improve the assimilation of new to practice RNs into the work environment. • Improve the assimilation of new leaders into their roles. 6

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    2019 NURSING ANNUAL REPORT STRATEGIC PLAN Engagement/Healthy Work Environments • Increase executive nursing leadership visibility. • Promote and enhance a culture of healthy work environments. • Improve physician/nursing collaboration. • Promote and support the health and well-being of our caregivers and leaders. 7

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    2019 NURSING ANNUAL REPORT PROFESSIONAL DEVELOPMENT Growth through Learning... By: Sarah Wu, MSN, RN-BC Clinical Educator A little about the CFLI Center For Learning and Innovation—CFLI We have moved from a nursing education depart- ment to a system-wide education department with the goal of supporting a culture of lifelong learning and continuous professional growth and develop- ment of the NCH workforce. My goal as a clinical ed- ucator is to support staff from across all depart- ments in our journey to “learn, teach and grow to- gether.” Becoming a Clinical Educator Working in critical care 20 years ago, in Colorado, I filled in to teach a class on Intraaortic Balloon Pump course to a group of novice ICU staff nurses. I was so nervous to teach, and now that I look back, I remember that was a turning point in my career. I moved into a formal educator role shortly afterward and “I always tell new nurses to trust their gut have been doing what I love ever since! feeling, ask LOTS questions and to be patient with themselves. Learning to “be a Proud to Support Our Team Members Growth & nurse” takes time!” - Sarah Learning A couple months ago, I had a staff nurse Programs I support in the CFLI: thank me for serving as her ACLS instruc- • Lead educator for clinical orientation tor. She had recently been involved in a • Nurses, Clinical Technicians, Patient Safety Technicians, Pa- tient Care Associates, Monitor Technicians and Unit Secre- Code Blue and she said she could hear taries my voice coaching her through the re- • Coordinator of the Nurse Residency Program suscitation attempt. While she was nerv- • Coordinator of Charge Nurse and Clinical Leader Academies ous, she reported that she knew how to • Coordinator of the Nurse Manager Academy • AHA BLS Course Director 8 respond to the situation because of • BLS, ACLS and PALS Instructor what she had learned from the class.

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    2019 NURSING ANNUAL REPORT PROFESSIONAL DEVELOPMENT Opportunity & Access By: Risa Wildeman, MSN-NE, RN Clinical Educator—Medicine Services Student Clinical Coordinator Supporting Learning Experiences I support the placement and on-boarding of all non-advanced practitioner students at NCH. Students across the region come to NCH for their clinical experience. We currently support multi- ple nursing schools with students on our units. Students from various specialties come to NCH for their clinical experience; inpatient and outpatient. NCH not only supports nursing students in their clinical experi- ence, but we have students from multiple specialty areas, who also come to NCH for their student clinical experiences. You might be interested to know the variety of students whose learning experiences we support at NCH: Cardiac Sonography, Cardiovascular specialty areas, EMT’s, “Treat your patients as you Exercise Wellness, Various Healthcare Administration areas, would want yourself or your family member to be treated. Lab, Nursing specialty areas, OT, Paramedics, Pharmacy, PT, They are at an insecure, un- Radiology, Respiratory, Sonography – US, Speech, Social predictable time in their life work, Surgical Techs, various additional preceptorships. while they are being cared for - Love them and bless them with all you have!” - Risa Programs I support in the CFLI: Lifelong Learning As an educator, my goal is to guide the under- • Student Placement and On-Boarding: standing of critical aspects of patient care • Clinical Educator for the Medicine Service through the development of knowledge and Line: Ambulatory, Radiological services, skills. The first step in the Nursing Process is to Laboratory services assess, and that’s how I approach education as • Instructor for BLS and ACLS well. Being a life long learner is so much of who I am that I bring this passion to support all of our • PowerChart Orientation students in their educational endeavors as well. • Alaris IV Pumps, PCA’s and Cerner In this role, I feel I have played a part in their Interoperability professional healthcare career develop- ment. 9

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    2019 NURSING ANNUAL REPORT Recruiting Top Talent In 2019, we recruited and welcomed almost 650 new team members into the Nursing Department. 331 Registered 78 Clinical Techs 7 Nurses Patient Safety Techs 41 21 7 Unit Monitor Advanced Secretaries Techs Practice RNs 12 20 19 Medical LPNs OR Techs Assistants 9 Patient 102 Care PSRs Associates 10

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    2019 NURSING ANNUAL REPORT Transition to Practice In 2019, 49 RNs completed fellowship pro- grams in the following specialties: • Critical Care (15) • Pediatrics (3) • Neonatal Intensive Care (2) • Mother/Baby-L&D (4) • Emergency Department (11) • Operating Room (4) Fellowships are held throughout the year. If you are interested in learning a new specialty, discuss your interest with your educator, or contact the Center for Learning and Innovation. In addition, NCH supported 98 Nurse Residents Clinical Educator Anne Mellema, MSN, RN, NPD-BC, CCRN, CMC, who transition to nursing practice during their CSC, CV-BC, SCRN rounding in Critical Care with our Fellows. first year of nursing. Collegial Relationships Our Care Delivery System (CDS) provides the structure that defines operational pro- cesses, such as patient assign- ments and care delivery. As an extension of our Professional Practice Model, which places the patient and family at the center of our care, the CDS represents how we deliver care. Collegial relationships with our interprofessional team members, like our Unit Secretaries, Physician, and Ancillary Colleagues are foundational to meeting and exceeding clinical outcomes and providing the best possible experi- ence. An example of the interprofessional team working to- gether for our patients is the Multi-Disciplinary Rounds. Many units today across our system participate in MDRs, placing the patient and family at the center 11 David Tanis, Unit Secretary of our care.

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    2019 NURSING ANNUAL REPORT By: Shelly Callender, MSN, RN, CPEN Director of School Health Program School health nursing 11 School 2 Health Coordinators Assistants 117,517 Student I joined NCH in November 2019 and provide leadership to our highly skilled school health Encounters 9 nursing team. My background in nursing is 28 Licensed in Neonatal and Pediatric Critical Care Registered Transport, Emergency Department, Leader- Practical Nurses ship/education, Public Health, and academ- Nurses ia. I am proud to work with such a diverse team who has such an impact on our com- munity. Our healthcare team provides care to 50 public Collier County Schools. Keeping our Children Safe & Healthy Our team had 117, 517 student encounters in the 185 school day academic year in 2018-2019. Our school nurse staff to student ratio is 1/980. Encounters include IHP (504), IEP consults, rec- ord reviews, immunization follow ups, medica- tion administrations, and first aid. Additionally, our NCH School Health Nurses perform complex medical procedures including catherization, tube feeds, asthma care, diabetic care and seizure disorders. We support students and families by making referrals to NCH Pediatric and specialists when necessary. Our nurses are autonomous in their daily decision making. There are many initiatives within our department including increasing the number of certified nurses and promoting advanced degrees. Our team is committed to the wellness of the children of Collier County while they are in school but are also in- volved in community initiatives such as NCH Safe & Health Children’s Coalition of Collier County. Additional focus this year will be identifying and supporting our at-risk population of students through assessments and providing resources within the community to help our children to be healthy in school. 12

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    2019 NURSING ANNUAL REPORT NCH Physician Group By: Michelle Gulley, LPN Academic Internal Medicine—GME Clinic Licensed Practical Nursing I have had the privilege of being an LPN with the NCH Healthcare System since 2004. It is over this time that I have watched the role of the LPN evolve and change with ever- changing community that we serve. Particularly amongst the physician group, I have had the opportunity to serve the peo- ple of Collier County. The role of the LPN in the physician group is one of caretaker, educator, and most importantly patient advocate. We spend our days working one on one with our patients to help them achieve optimal results and maintain a healthy life. This includes, but is not limited to, patient educa- tion, assistance with follow up care, referrals and health care maintenance. We work closely with the physicians, community programs/resources to help ensure that our pa- tient’s needs are met. While everyday is different, our goal remains the same and that is to offer the highest level of care and compassion to the people in which we serve. NPG Metrics 130,000+ 20+ unique specialties patients 800,000+ Total Patient Encounters 500+ 38+ Associates Locations 13

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    2019 NURSING ANNUAL REPORT Nursing Care Management By: Erin Raney MSN, RN, CNML What is Population Health? Assistant Director Population Health Population health focuses on improving the health status and outcomes of our patients and community. The social determinants of health are used as the basis for patients to achieve optimal health and quality of life. The population health team works with patients and their families or caregiv- ers to identify and address any barriers that exist in these areas and focuses on the prevention of acute and chronic conditions through tracking of preventive screenings and other testing that can be Population Health used to predict the onset of future chronic disease. Quality metric data is tracked and reported to CMS as part of our Accountable Care Organization (ACO), which began in January 2018. The goal of the ACO and similar programs offered through other insurance payers is to provide pa- tient centered, high quality care in the most cost-effective manner and in the most appropriate setting. Programs Leading to Progress One of the programs included in our population health efforts is Chronic Care Manage- ment. This program offers telephonic case management support to the patients we serve. Pa- tients that have two or more chronic conditions and/or barriers in the above areas can be re- ferred to the program by their healthcare provider. They will receive monthly (or more fre- quent) calls from a case manager to work on goals that are established by the patient, their family or caregivers, and their healthcare providers. The information discussed during the calls is communicated back to the healthcare team and the care plan is adjusted based on individual needs and progress. We also have a case manager dedicated to the needs of the high utilizer and behavioral health populations. In 2019, we had 2300 telephonic patient encounters. Our team is comprised of Assistant Directors, Case Managers, Quality Data Analysts, and a Patient Service Repre- sentative. NCH Nursing Care Management team 14

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    2019 NURSING ANNUAL REPORT System Impact by the Numbers 13,391 30,993 Observations Inpatient 120,098 Admissions ED Visits 13,240 Surgical Procedures 3,430 Births 488 Open Heart 12, 273 Surgical Visits 15

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    2019 NURSING ANNUAL REPORT Learning and Innovation 89 A.S.P.I.R.E. Clinical Ladder 49 RNs Nurses 282 Completed 6 Fellowships 98 Nationally Board Nurse Certified Nurses Specialty Areas Residents 40 Hold More than One Certification 56 MSN 54 Scholarships $693,910 546 BSN Awarded Totaling Paid to Employees 1 PhD $72,171 Tuition 2 DNP Reimbursement Experts in our Field Do you want to demonstrate expertise and competency in your specialty area? Do you want to advance in your career? Do you want to validate your knowledge of your expertise in your area of nursing? NCH financially supports your National Board Certification goals (up to two exams and recertifications?) Contact the CFLI for more information. Ask about Scholarship and Tuition Reimbursement opportunities too! Julie Lee, BSN, RN and Fifi Cange, CT served as skills validators at one of our several Skills Fairs in 2019. 16

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    2019 NURSING ANNUAL REPORT Advancing Healthcare Eight years ago, NCH began the A.S.P.I.R.E Clinical Ladder Program. In 2019, 89 Professional Nurses climbed the ladder. In the same year, the program was redesigned and renamed to E.X.C.E.L. We are proud to support and recognize professional nurses who advance healthcare in our community. We believe our certified nurses have a profound impact on our patients and our community. In 2019, several service lines held “Skills Fair Days” to provide an in-depth learning immer- sion for their teams. The Orthopedic Team (pictured on the right) participated in a full day learning event. Activities such as Skills Fairs, Learning Immersions, Nursing Grand Rounds, and Journal Clubs are excellent examples of our nursing department advancing healthcare for everyone. Lifelong Learning In the Fall of 2019, Damia Champagne, LPN, with leadership support by leader Reggie Holly, of Concierge Medicine, organized an educational event for the three NCH Conci- erge Offices: North (Drs. Haven and Hanson), South (Drs. Swain and Southmayd), and Central (Drs. Goldstein and Contreras). Damia coordinated the learning event to sup- port continuous learning among her peers in the ambulatory setting with a focus on best practices for clinical care in addition to current information in patient education. 17

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    2019 NURSING ANNUAL REPORT Celebrating Excellence There are many ways we celebrate excellence throughout the year at NCH. The DAISY Award celebrates Extraordinary Nurses, Leaders, and Teams. There are over 3,000 DAISY Hospitals around the world, and we are proud to be one of them. The CARING Award is a homegrown recognition program, born out of our Professional Practice Nursing Council in 2017. Currently, Nursing Shared Governance is working on an award to support recognition across the system; “Consider It Done!” that will celebrate excellence across the system; open to all employees. Honorees 12 DAISY 12 CARING 2 DAISY Leaders 1 DAISY Team 317 CARING NOMINEES 902 DAISY Carolyn Paget, BSN, RN, ONC & NOMINEES Karen White, BSN, RN-BC Seniority Perks Three years ago a group of Med/Surg nursing staff from across the hospital system met to establish a perk system that would recognize and reward longevity for nurses working in med/surg nursing. These nurses developed the footprint for the Seniority Perks Program. That first year it started with med/surg nursing,but quickly expanded to include Med/Surg CT’s, Med/ Surg US’s, WCP Nurses, ED nurses and CC nurses. Each area has a variation of the program tailored for their specialty. A full list of the Seniority Perks Program, by specialty, can be located on the Nursing Home Page on My NCH. 18

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    2019 NURSING ANNUAL REPORT Recognizing Excellence Every May, during National Nurses Week and National Hospital Week, NCH recognizes our amazing team for their excellence in care. Last year, 16 honorees were recognized and over 380 nominees celebrated at the Naples Grande Beach Hotel. A full list of nomi- nees, honorees, and photos can be accessed on the Nursing Department page. Myriads of Gratitude! We can never say thank you enough to our very special team member Kathy Lenard. She is our amazing Associate Executive As- sistant for Nursing Operations. Kathy works tirelessly behind the scenes to keep our nursing department moving forward. Addi- tionally, she is an integral member of our recognition committees, patrols, events, cer- emonies, simply would not be possible with- out her. Thank you Kathy! 19

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    2019 NURSING ANNUAL REPORT Quality Improvement & Innovation January 2019 marked the 2nd Annual Research, Evidence-Based Practice, and Quality Improve- ment Conference and our 5th Annual Quality Improvement Poster Session where 39 projects were proudly shared by the staff. It is clear that our organization is committed to continuous im- provement and delivering high quality care and services. You can view all Quality Improvement Posters on the Nursing Department page, under the Quality Posters tab or click Quality Posters You can also view John Nance’s keynote presenta- tion. John Nance - Keynote Speaker 2019 Our focus on continuous improvement supports our culture of excellence. Another example of continuous improvement is the work that is being done with the Shared Governance struc- ture. Nursing Congress meets bi-monthly and reports on quality improvement initiatives oc- curring at the unit , department, and system level. Collaboration and structure problem solv- ing occurs during Nursing Congress. 20 Nursing Congress convened December 2019

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    2019 NURSING ANNUAL REPORT Future of Nursing The redesigned Shared Governance Council structure Shared Governance Jo Loewel, RN Julie Lee, BSN, RN provides Nursing Department team members, at all Nursing Excellence Council Co-Chairs levels, the ability to contribute collaboratively to the ownership of nursing practice, standards, and quality of care and to effectively respond to change. Shared Governance is founded on the cornerstone principles of accountability, equity, ownership, professional obligation, collateral relationships, and effective decision-making. Nursing Excellence Council With a focus this year on identifying and supporting excellence, Council Chairs Jo Loewel & Julie Lee round regularly across the system con- nect with members from various units and clinics. They are the positive change agents who brighten up the day of everyone they meet . Michelle Atkinson, RN & Denise Schmidt, US Nursing Congress Co-Chairs Nursing Congress Considered the “glue” that holds Shared Governance together, Nursing Congress meets bi-monthly, on the even months. Shared Governance leaders at all levels share quality improvement initiatives, network and collaborate with team members across the system, and participate in professional development exercises. 21 For more information about Shared Governance, please visit the Nursing Depart- ment page on the myNCH.com

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    2019 NURSING ANNUAL REPORT Nursing and the Community The Orthopaedic Service Line, lead by Suzanne Graziano, MSN, RN, ONC, NE-BC, CNAT supports many community outreach events throughout the year. As experts in nursing care of the orthopaedic patient, Sue empowers her team to promote health and wellness outside of the hospital. The Annual Mobility Beach Walk In our community, there are many folks who are wheelchair bound or use assistive devic- es to walk. Going to the beach is often times not even considered as a possibility. Howev- er, last year, approximately 40 members of our Gulf Coast community who relied on assis- tive devices to move where guided by the NCH Nursing Orthopaedic team in collaboration with Stephanie Gomez. Patients who had not put their feet in the sand in years because their walkers would get stuck, were guided by nurses and walker skiis. Wheelchair bound members were guided to the water in other beach cruising devices so they could put their feet in water. Some folks hadn’t been to the beach in years! Pickleball Tournaments NCH Orthopaedic Nurses, Physical Therapists, and Athletic Trainers support Regional Pickleball Tournaments. Clinicians support athletes that may become injured while play- ing throughout the day. As the only healthcare system sponsoring these events, having clinicians on site provides point of care treatments and also recommendations for follow up with any NCH Sports Medicine or Orthopeadic Services. Providing compassionate and knowledgeable care to our community is another reason NCH is a cornerstone for health and wellness in our community. 22

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    2019 NURSING ANNUAL REPORT In Memory of Diane Catalano July 24, 1969—December 20, 2019 Diane was an integral part of the NCH Vanderbilt Immediate Care team. She is re- membered for her infectious smile and her love of baseball (Go Cards!). She was not only our colleague but our friend. She was a daughter, a mother to two sons, and a grandmother to five. She is remembered for rendering extraordinary patient care and she was notorious for her commitment to her team. There was never a time in which Diane didn’t take on any task head-on and she did so with that smile on her face. Diane began a tribute in which the Vanderbilt team would wear red every Friday to re- member everyone deployed (R.E.D.), to honor her son’s deployment. In turn, her son has made a patch to begin his own campaign--remember every nurse (R.E.N.). Diane was also a dedicated nursing student at Florida Southwestern College. She was one semester away from finishing. So, let’s all take a page from the Catalano family and make sure we honor R.E.D. and R.E.N. This is written in dedication to Diane and her family. Diane, please rest in the sweetest of peace. Contributed by Anthony Silva, CCMA, ROT, Lead Medical Assistant/ Regis- tered Orthopaedic Technician. 23

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    2019 NURSING ANNUAL REPORT Professional Performance The Standards of Professional Performance describe a com- petent level of behavior in the role demonstrated through engagement in professional role activities related to: ethics, culturally congruent practice, communication, collaboration, leadership, education, evidence-based practice and re- search, quality of practice, professional practice evaluation, resource utilization, and environmental health. Ultimately, the Standards of Performance largely influence nursing prac- tice. See Figure 2 Standards of Performance NCH Programs/Initiatives (Professional Role Activities) Standard 7. Ethics Professional Practice Model Standards of Performance Standard 8. Culturally Congruent Prac- Care Delivery System tice Annual Nursing Report Standard 9. Communication The CNO Current Standard 10. Collaboration Nursing Forums Standard 11. Leadership Shared Governance Model and System Councils Standard 12. Education Unit-Based Councils Standard 13. Evidence-based Practice Leadership Academies (*CFL) and Research Tuition and Scholarships (*CFL) Standard 14. Quality of Practice Professional Certification (*CFL) Standard 15. Professional Practice Preceptor Programs (*CFL) Evaluation EXCEL and STRONG Clinical Ladders Standard 16. Resource Utilization Annual Quality Fair and Awards Standard 17. Environmental Health Annual Research, Evidence-Based Practice and Quality Improvement Conference Peer Feedback Nursing Engagement Survey and Plans Annual Nurses Week Celebration Nursing Excellence Awards DAISY and CARING Awards Seasonal Nurse Celebration Professional Certification Celebration Figure 1 24

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    2019 NURSING ANNUAL REPORT Professional Practice Standards of Practice The Department of Nursing Professional Practice Led by Ilia Echevarria, ACNO of Professional Practice and Christina Car- ranza, Coordinator of Professional Prac- tice, facilitates programs and initiatives to ensure alignment with the Standards of Performance (Figure 1). The Standards of Professional Nursing Practice are com- prised of the Standards of Practice and the Standards of Professional Perfor- mance (Figure2). The Standards of Practice describe a competent level of nursing care demon- Ilia Echevarria, PhD, MS, RN, CCRN-K, NEA-BC, CENP, CHES strated by the nursing process: assess- Associate Chief Nursing Officer, Professional Practice ment, diagnosis, outcomes identifica- tion, planning, implementation, and Christina Carranza, MSN, RN-BC, CNML evaluation. Professional Practice Coordinator Standards of Practice NCH Programs/Initiatives (Nursing Care Competence) Nursing Process: Nursing Orientation Standard 1. Assessment Annual Skills Fairs Standard 2. Diagnosis Learning Labs Standard 3. Outcomes Simulation Learning Identification Fellowship Programs Standard 4. Planning Nurse Residency Program Standard 5. Implementation Standard 6. Evaluation Figure 2 25

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    President’s message 2019 NURSING ANNUAL REPORT When I arrived on campus this past September, it was clear to me that NCH was more just a hospital. NCH, the award-winning health system, was comprised of two amazing hospitals, a number of easi- ly accessible facilities, and a staff of truly terrific healthcare profes- sionals and physicians. As amazing as NCH is, what excites me most is being part of what NCH can become. Previously, I had been the CEO of medical groups, accountable care organizations, and acute care hospitals, but NCH feels different. For me, this job is about connection to the community, partnerships with doctors, and excellence in patient care, all of which I am pas- sionate about. Within my first days, Hurricane Dorian served Southwest Florida a brief Paul Hiltz President and CEO threat; however, I immediately witnessed NCH teamwork that was in- NCH Healthcare System spirational. Luckily, the hurricane turned out to have minimal effect, but medical staff was still more than ready to serve the community, and I applaud that. It quickly became obvious how vital communication and collaboration are to the organization, and I was glad that this was something we all had in common. With open communication being of the utmost importance to me, I integrated myself by engag- ing with as many people as I could through my 90-day listening tour. Throughout those 90 days you’ve given me a lot to think about. I’ve made it a point to connect with community members, physicians, nurses, administrators, and staff so that I could better learn about NCH from the people that serve this community so well. Beyond the focus on quality and care, I quickly realized that many wanted a greater emphasis on making this a true community hospital where all physicians are welcome. I thoroughly agree. I’m also proud to witness the beginnings of our Emergency Department renovation project. This two-year, multi- million-dollar expansion project will be well worth it by improving patient satisfaction, patient safety, and patient privacy. In December, we held our 61st annual Hospital Ball, where we enjoyed the company of 350 guests and together raised over two million dollars. Additionally, during the ball, three of our board members purchased germ-zapping robots that will fight disease and infection in our hospital. For that, I’d like to extend a sincere thank you to Mari- ann MacDonald, Jay Baker, and Scott Lutgert. At NCH, we’ve established ourselves as a healthcare system of world-class quality, and we’ve received the acco- lades to prove it. This year, we earned four stars from CMS, which is the gold standard quality ranking system in the country. We also learned that Healthgrades named us a top 100 hospital in America for seven specialties, and once again, U.S. News & World Report named NCH a best regional hospital, ranking us #14 in the state. This past year has been full of change, however, one thing that has remained constant is that NCH will always be a community health system that we can be proud of. Until next time, thank you and I look forward to continuing our mission in the many years to come. 26

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    2019 NURSING ANNUAL REPORT Annual Report credits Writer, Editor, Photography, Design: (above) Christina Carranza, MSN, RN-BC, CNML Contributors (in descending order): Ilia Echevarria PhD, MS, RN, CCRN-K, NEA-BC, CENP, CHES Anthony Silva, CCMA, ROT Evelyn Stevens MBA, BSN, RN Cover design: Jake Jones & Christina Carranza MSN, RN-BC, CNML On the cover, from left to right: Karley Martinez, BSN, RN (3 W Medical Surgical), Evelyn Stevens MBA, BSN, RN, (4 South Oncology), Al Sotelo (Unit Aide, Operating Room), Michelle Gul- ley, LPN (GME Clinic), Lisa Arnold, BSN, RN, NCSN (School Health Nursing) —LEAD—INNOVATE— EXCEL— 27

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    Friends of Nursing 2019 NURSING ANNUAL REPORT Meet the Allyn Family: The Allyn family are wonderful friends of NCH and have donated to help us improve our care and invest in our team members development (NCH Scholar- ship Program, for example, and various development support programs). This past year, money the Bill & Penny Allyn Allyn Family has donated was used to purchase a Xenex Disinfectant Robot. These robots will help prevent hospital acquired infections and improve the quality of care we deliver at NCH to our community. Bill worked with nursing to name the life- saving robot in her Penny’s honor. The Allyn’s love our NCH nurses and we are grateful for their gracious support and commit- ment to ensuring our nursing care is the best in the community, now and for years to come. For additional information about the Department of Nursing, please visit our website: NCHmd.org To contact our Center for Philanthropy, please contact 239-624-2000.

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