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Latest News From PNCC
| 7/26/2010 |
JULY 2010 PNCC MINUTES |
| PNCC JULY MEETING MINUTES July 5, 2010 Attendance: Karen Stanard, John Nangle, Dana Peters, Leanna Leyes, Selena Smith, Kathy Phillips, and Marie Barnes Open Discussion: • Discussed the proposal of merit raises and the process of our annual evaluation. Is the evaluation appropriate regarding nurse related care and skills. Also, is merit raises really the way to go. Discussion to look into the evaluation and possibly addresses this in the future. • John is going to find out to how to place our PNCC award in the case on the 2nd floor outside the elevators. • Crucial Conversations discussion regarding first few chapters of book Product Committee Update: • Dana discussed the process of how us nurses get a new product in the hospital and has a flow sheet available if you want to know the process. Dana also spoke that they are going to be downsizing the committee so John is going to contact Dan to make sure PNCC is part of the committee and voting within the product committee. • Trialing a new shower glove on IMCU that will cover PICC lines during the patient showers to protect the line. • Disposable blood pressure cuffs are still in discussion if they truly decrease infection risk, cost effective, etc. Dana is going to discuss at next committee meeting adaptors for IMCU when patients arrive from Cath Lab with disposable cuffs so IMCU doesn’t have to throw them away and reapply another cuff and be wasteful with time and money. • RDM CEO putting a push on standard hand sanitizer throughout SCHS. Foam is going away and committee is going to be trialing different sanitizers to find the right one. Clinical Practice Committee to be July 7th. Update at next PNCC meeting. Funds/Education Committee: • Karen discussed rollover funds per unit are left over from the last 3 years (this is the last of it, so no more rollover). The left over amount to be dispersed is $14,756 to be used by December 15, 2010 in the units of: Airlink, Heart Services, Radiology, Rehab, OR, PAR, Surgery Center, NICU, Peds, and PreSurg. Karen has contacted these units and waiting to hear back to know what/how they want to spend the money. The rollover funds are divided into these units depending on how many nurses are on that unit which equals $68/RN. • Flier will be sent out (through email and posted around units) to remind RN’s to use PNCC funds by December 15, 2010 • New form for PNCC Fund Request Application has been made and will hopefully be sent out to the floors soon. Date to be announced when known. • Discussion regarding using funds on conferences versus personal RN use for education. We will look into possibly planning a conference in the spring by using funds that are left by December 15th to pay for speaker before we lose the money. PNCC funds left in budget is $90,507.92 • John Howes will be at our next meeting to meet him and discuss his role in education as the new organization education director in HR. Optimization Committee: • Errors are still continuing although Mary is a physician who is going to reorganize committee and hopefully become more effective. ???????? JOHNNY PLEASE ADD Fall Risk Committee: • Hourly rounding will be implemented into new fall risk protocol. • Final approving on fall risk protocols with is taking place by September 1st. Releasing Time to Care, Productive Ward, Lean Project (which ever name we choose): • Selena will be going to England to help set up and begin the lean project that will be a pilot program on IMCU. This project is set up to give nurses more time to care for their patients by being more organized, improving morale, patient satisfactory, financial savings, etc. Pam Steinke, JoAnn Miller-Watts, Carey Pulido, and Selena Smith will be traveling to the UK for 1 week leaving July 17th. When Selena returns, she will present more information on rolling this project out in the August meeting. Next Meeting: John Howes from HR Selena on IMCU pilot program Committee updates Is our award in the showcase? John to speak with Dan in regards to PNCC on Product voting Committee Crucial Conversations |
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| 6/23/2010 |
APRIL 2010 PNCC MINUTES |
| PNCC Meeting Minutes April 5th, 2010 0900-1130 Attendance: John Nangle, Selena Smith, Marie Barnes, Karen Stanard, Lynda Coats, Leanna Leyes, Terri Lewis, Marta Izo, Kathy Phillips. General report: - Staphanie Charila to join PNCC as Green Council Liason. - Marie Barnes is working on a better PNCC hours tracking system, including a new hours/work sheet. - Selena: CPC reports that the Fall Risk Protocol will change to make everyone a fall risk, this will get forwarded to PNCC ASAP. - Lynda Coats reports on STF COMM: O/N / SSC Consolidation plans. Not totally thought out. - Marie Barnes on Product Eval: Dana looking into IV tubing changes planned. Foley tray without bags are being eliminated. Some staff concern regard Braun IV tubing bags safety. - Leanna Leyes reports that UPC’s are meeting quarterly. PNCC wants to get more proactive in aligning with UPC’s. - |
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| 6/23/2010 |
MAY 2010 PNCC MINUTES |
| PNCC Meeting Minutes May 3rd, 2010 0900-1130 Attendance: John Nangle, Marie Barnes, Leanna Leyes, Terri Lewis, Kathy Phillips: General: - Education: Kathy reports on the CC presentation. We have xtra books and will make them available to folks over time. PNCC will plan to cover two chapters per month on the CC book. PNCC plans to sponsor the AACN Cardiac education planned for August. - Marie Barnes is tracking PNCC hours either fill out the hard copy or send in PNCC hours via email. - PNCC to present at Contract Negotiations for article 13 & 14 changes this month. Plan to have Pam Steinke present to PNCC June meeting her Shared Governance vision as set out in the UPC Chair retreat / Quarterly. |
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| 6/23/2010 |
JUNE 2010 PNCC MINUTES |
| PNCC Meeting Minutes June 7th, 2010 0900-1130 Attendance: Marie Barnes, Leanna Leyes, Dana Peters, Marta Izo, Lynda Coats, Karen Stanard, John Nangle, and Selena Smith Topic: Shared Governance and Lean Project for IMCU Speaker: Pam Steinke Pam discussed shared governance in regards to triple aim (improve patient experience, improve health population, and control costs), structural alignment with management and clinical practice, new quality motto of “think lean, solve problems, and improve care”. The synergy of structure would be to work together with management. Principles would include accountability, relationships, ownership, and equality. All of this would be placed in UPC charters. We also need to re-focus on patient care with management operations, clinical practice performance, excellence, and education. John spoke about more caregivers’ time to process and commit time to excellence. Karen mentioned example of case reviews being taken away from E.R due to budget cuts, which were important to the E.R team. Topic: Rehabilitation Process Speaker: Meg P.T with Dave and Bill Meg discussed the importance of rehab being ordered when a patient’s baseline functional ability has declined. Patients that qualify are those that have skilled need, can learn, have the ability to progress, need for family training, or staff education (positioning, lifting/transfers, etc.). If the goals were met, a therapist would then be able to discharge a patient from therapy. When caseloads are too high, then the patient would be triaged for discharge. Therapy for patients includes: Stairs, stability, TENS units, pain management, orthotics and prosthetics, education, activity tolerance, vestibular/oculomotor systems, etc. Therapy also reviewed the Independent through Dependent definitions that a patient requires for safety. Physical Therapy and Occupational to use white board for references re: transfers, toileting, etc., although PLEASE look at Daily Notes in McKesson to find therapy. Speech Therapy will also document in Daily Notes, but also look to the PINK SHEET placed at head of bed for swallowing recommendations. We also need to be checking meal trays for those patients on restrictions for consistency of food and liquids. Lynda asked that Bill look into shifts that go later into the evening (around 2100) for education with fast track joint patients that will be discharged the next morning who need therapy. Bill said he is open to that request and will look into that with staffing the therapists. Dana also asked how to utilize therapy in E.R. Both Meg and Bill commented that therapy is available to do consults in the E.R for those patients that need assistance prior to discharge. Meg is going to get a functional sheet to E.R that would help screen patients for safety. Committee Updates Staffing Committee: PACU nurses will be changing positions around due to lay offs within that department. Junior nurses within PACU will be offered other positions throughout SCHS. Ortho/Neuro nurses will also be offered other positions throughout SCHS due to consolidation of units and low patient census. Staffing continues to look at call offs and the language in the contract. Also due to the staffing law, they will begin to look at giving employees uninterrupted breaks. CIWA has been successful since implementing. Nurses are able to capture patients at high risk for alcohol withdrawals. Clinical Practice Committee: We need to be aware of documentation and orders. Certain physician orders need to be corrected, care plans are not being complete, IV antibiotics need a start AND stop time, giving supplies away to patients being discharged when physicians ask nurses to, etc. All these things are looked at as incomplete documentation and SCHS are not being paid due to these errors. Risk management has issues regarding timely notification of events that take place for quick updates and are addressing how to make this more effective. Press Ganey has increased according to committee, although Pam CNO stated it has gone down. Dilaudid syringes are not working well therefore we will go back to the old syringes until the kinks are worked out of the new model. July 20th will be down time for McKesson for an 8-hour update within the system. Product Evaluation Committee: Remedy hand lotion will be taken away, although if employees are experiencing dermatitis then they need to go to Diane and she will give individual packets due to cost. TB syringes will be replaced with luer lock syringes due to safety. The old syringe did not lock with needle and has disconnected leaving the needle in the skin. This change will be taking place immediately. IV start kits will NOT have the small vial of ChloraPrep but will hopefully be replaced with sponge prep for the skin. Disposable blood pressure cuffs are still being decided on whether to standardize all cuffs to disposable or leave as is. At this point, it does not seem clear that the evidence- based information supports the decreased risk of infection from patient to patient. Mepilex Brand silicon dressing for wounds will have a window to peak at the wound without having to take the dressing off for assessment. Dana to inquire about trials being done at smaller hospitals within St. Charles Healthcare System for new equipment and decisions being made due to their decreased volume of patients as compared to Bend campus. Optimization Committee: Looking to re-organize committee since the current situation is overloaded with medication administration issues. We are reassured that the end users will be part of the committee. NEXT AGENDA: Cardiac Education Conference in partnership with AACN Rollover Update |
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| 3/12/2010 |
MARCH 2010 PNCC MINUTES |
| PNCC Meeting Minutes March 1st, 2020 0900-1130 Attending: John Nangle, Karen Stanard, Lynda Coats, Leanna Leyes, Terri Lewis, Kathy Phillips, Marie Barnes, Selena Smith. Joe Sack gave the PNCC an update on the Negotiating Team schedule. He will be the contact person for the PNCC contract language we would like to address. Thanks Joe. Lusine Sarkisian, IMCU Manager, has been tasked with re-writing the Fall Risk Protocol and is requesting that PNCC have some representation on the committee she is creating. The PNCC greatly appreciates her request and we will plan to have Lynda Coats and Selena Smith join her committee. Kathy Phillips will assist in finding a MSVS UPC member to join Lusine, and John Nangle will assist in finding Rehab representation. Thank you Lusine. Bonnie Reid, Clinical Educator for Med/Surg, presented the PNCC with a house wide clinical practice issue, medication dilution. Apparently RN’s are using the ‘clean’ NS flush to dilute medication, and in the process they potentially contaminate the ‘sterile’ injection. The PNCC recommended a WI be created for SCMC Bend. Bonnie plans to put this together and email PNCC members for input. The PNCC thanks Bonnie for including us in this clinical practice issue, and we will work together to improve the clinical practice of diluting medication for IVP. John Nangle presented a “Formal Consensus” power point. Formal Consensus is a decision making tool within PNCC. This was adopted 2009 and is part of our Charter. There was healthy discussion on this process. We agree to use this as a guiding principle but not as a rigid process to strictly be followed. The PNCC is organic and flexible, but also highly principled! Kathy Phillips reviewed the Crucial Conversations presentation plans. The flyer was reviewed and some suggestions made for changes. Kathy will follow up with Deb Poplin on this. Thanks Kathy for your dedication to this big PNCC/CHC event! |
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| 2/25/2010 |
FEBRUARY 2010 PNCC MINUTES |
| PNCC Meeting Minutes February 15th, 2010 0800-1130 Attending: John Nangle, Lynda Coats, Selena Smith, Marta Izo, Dana Peters, Terri Lewis, Karen Stanard, Kathy Phillips, Marie Barnes, Leanna Leyes, Alison Hamway, Sue Davidson. Negotiation Update - Alison Hamway provided an update on contract negotiation plans. PNCC and the Negotiating team will be meeting next week to strategize. ONA is anticipating CHC to push for significant takeaways in our contract despite the EMR challenges forced on caregivers, and the caregivers excellent quality of care recognized in CHC’s recent PR being named in the top 50 hospitals. AACN: - Leanna Leyes provided information on the new Central Oregon AACN. PNCC looks forward to partnering with the AACN chapter. AACN may be looking at doing a cardiac education seminar/conference in 2010. The PNCC would be interested in helping out with this. PNCC Reports: - Staffing Committee: o Lynda Coats provided updates on NDNQI. We believe this new data set will be a better measuring tool for the Staffing Committee. o There is some discussion on what constitute an appropriate staffing % mix. 20% is likely to be agreed upon as appropriate. o On O/N the one FTE PT/OT reduction does not appear to impact nursing or patient care, but PNCC is not clear on how Dave Haglund (rehab manager) plans to track the impacts of this change. Dave and Bill Stacy (Rehab Supervisor) have been invited to the March PNCC meeting. Selena discussed the possible negative impacts of this on IMCU. PNCC will continue to pursue a better understanding of how this will impact nursing and most importantly patient care. o On IMCU the HPPD increase has been very successful for staff and patients. PNCC supports this change and will continue to support IMCU on their decision. - Education Committee: o Karen reports that over $60,000 PNCC funds were not used in 2010. Clearly the impact of EMR education has had a profound negative impact on continuing clinical education. EMR has literally consumed the nursing staff in 2009, a huge loss to continuing education at CHC. o PNCC continues to move in new direction of promoting a culture of education at CHC. Plans for our first “Crucial Conversations” seminar are moving forward. PNCC is excited about a new partnership with CHC clinical educators as we work together to promote education. - SRDF Committee: o Terri provided an update on SRDF forms. There are no hot spots at this time. o Marta Izo will be joining Terri in reviewing SRDF issues. We would like to get some education around filling out the SRDF’s to the nurses in 2010. o Sacred Heart has SRDF online in a Word document. Terri will contact them and see if we can move in that direction. Barb Kessler and Judith Chapiro are contacts. SCMC Committee Reports: - CPC Committee: o Leanna reports that Pam Steinke is planning some changes to the structure of the committee. Pam assured John Nangle during an RN/Pharm meeting that PNCC would be part of any new configuration. - Product Evaluation Committee: o Dana and Marie provided updates on the committee. The committee has a new meeting time: 4th Tuesday 1000-1100. - RN/Pharm Committee: o John reports that Pam Steinke attended the last meeting. It was decided by members to take a break until March and come back and redefine the goals of the committee. Members continue to feel strongly that McKesson needs to provide CHC with a MAR. The PNCC feels there continues to be significant patient safety concerns with the McKesson medication administration system. PNCC is also very concerned that CHC, after 8 months since go-live, has yet to track the hundreds of errors the McKesson system created and ONA RN’s prevented from reaching our patients. This was presented to Pam at the meeting, and she agreed it would be very valuable data. - IT/Educators: o John provides an update on the planned EMR continuing education. This has been delayed. Sue Davidson - Sue provided new members with PNCC binders and an excellent presentation on the PNCC role and empowerment of PNCC committees. - Jean Sago will be putting together her research on impacts of staffing levels, the report is anticipated to come out in June. - Carol Bickford with ANA works on EMR issues at the federal level. |
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| 1/22/2010 |
JANUARY 2010 PNCC MINUTES |
| PNCC Meeting Minutes January 18th, 2010 0930-1200 Attending: John Nangle, Lynda Coats, Marta Izo, Dana Peters, Terri Lewis, Marie Barnes, Audrey Hatfield. PNCC Committee reports: - Staffing Comm. o Lynda reports a new program to be implemented by Pam Steinke, NDNQI (Nurse Patient Quality Indicators). This can be viewed online. o Cross unit acuity audits have been going on. Some interesting results. The process is in review for it’s own merits. o LMI (Labor Management Data) for HPPD is viewable on the iDrive. Unfortunately this data does not do justice to our organization and so PNCC views it as having limited value. There are several other data sources across the country that would be of better value, but CHC at this time has not been interested in acquiring that. o The OT/PT reduction looks to be a trimming of unnecessary visits, and will hopefully not impact patient care negatively. PNCC will monitor the bedside effects of the changes over time. o IMCU HPPD increased to 11.5 for a 6-week trial. There is already a direct positive impact on patient care. This will be of great value to the IMCU and patient care. - SRDF Report: Terri has no new areas of concern. - Education: o PNCC has agreed to work on language changes for our WI and possible contract language regarding the use of PNCC funds. PNCC would like to provide educational offerings for ONA RN’s in addition to reimbursements for education. Thus some of the annual funds would be used to pay for in house education offerings. o Planning has begun for our first educational offering: Vital Smarts seminar supporting the popular “Crucial Conversations” book. PNCC would like this to be a collaborative effort with CHC Educators and possibly the new AACN chapter. - CHC Committees: o CPC: Leanna and Selena will share in representing nursing. o Product Evaluation: Marie and Dana are set up to represent nursing and provide their clinical knowledge. o UPC Chair: Leanna and Kathy are both on their respective UPC’s and will represent PNCC at the quarterlies. o Safety Committee: Audrey and Terri will represent nursing. Theresa is happy to have them. o RN/Pharm: John reports wide sentiment of frustration within the committee as to our direction and limits to what we can achieve. The letter to Administration in November needs to be revisited. Members all want more from what McKesson has been providing us. Patient care continues to be a very real concern, and needs to be our driver. o IT/Educators: John reports the upcoming train the trainers will begin next week. There is a wide sentiment of frustration with all the nuances to fixes, and a real concern with how much nursing can retain with this format. The most recent fix with H&P causes problems of it’s own. Nuance fatigue maybe real. McKesson: PNCC members state that nurses have been reporting managers going over overrides with them. This is not consistent throughout the organization. PNCC feels there is absolutely no standard of care right now with medication administration. The expectation of nursing regarding medication administration is not supported by the McKesson EMR. PNCC continues to feel that McKesson is not providing nursing and our patient’s with a safe system. There needs to be ‘one source of truth’ for all medications and a function to provide those medications from that one source. This would create a standard of care worthy of the care CHC provides. Our patients deserve no less. 2010 PNCC goals adopted: - McKesson improvements. PNCC will continue to support and work for positive change to our EMR. Medication administration continues to be a patient safety concern and our main focus. - Foster lasting relationships between PNCC and CHC committees. - Education fund changes. Provide more educational offerings in house for ONA nurses. Develop relationships with CHC educators and new AACN chapter, and work together on fostering a culture of education at CHC. - PNCC outreach. Do a better job of communicating to CHC and the ONA RN’s we represent on who we are and the work PNCC does. Sue Davidson will attend our February meeting. |
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| 1/4/2010 |
DECEMBER MEETING MINUTES |
| PNCC Meeting Minutes December 21st 0930-1200 Attending: John, Selena, Kathy, Marta, Terri, Leanna, Lynda, Marie, Dana PNCC Committee elections results: - Chair will be John - Co-Chair will be Selena Committee reports: - Staffing Comm. Lynda: o Planning to look at quality indicators, and will include nurse satisfaction. o Sue Davidson has contacted a researcher to look at nurse intensity at facilities across the country. We would like to invite her to CHC at some point. o NICU core staffing issue was due to communication, and their core will be increased to 7. o New staffing software to be reviewed. Lynda has been invited to be part of the review process. - SRDF Report. Terri: o NICU spike in reports was associated with the core staffing issue, and has been resolved. Not many reports coming in this past month. - Education. Kathy/Karen: o Karen was absent. Kathy reports that they will be getting together early Jan. 2010 to make plans for the last of the rollover funds, and review goals for 2010. - Administrative Committees: o McKesson Change Priority Comm.: John/Selena report that the first McKesson Change priority meeting convened. This is being headed up by Elizabeth Larkins and Dave Rose (IT) and is comprised of clinical people from all areas of the hospital. The goal is to make sure we are working on all the critical problems of McKesson (which we are) and to prioritize the next levels of changes we need. This committee will NOT meet regularly, but will communicate via email. IT will be working on ways that change requests can be made, and ways changes being worked on and/or resolved can be viewed. This would likely be an area on Caregiver Net. We’re hopeful that McKesson can be what we really need it to be. Clearly Administration and Nursing are on the same page, and we are all working together to make McKesson productive and safe for patient care. o RN/Pharmacy Comm.: John reports that the committee will now meet every other week, as many smaller issues have been worked out. The big issues that linger are taking time to work out. No definitive word on the Committees’ statement to Administration regarding ‘One source of truth’ for MedAdmin.. This is the largest patient safety issue going on with McKesson and it must change. Meanwhile caregivers are spending countless hours “getting around” the system. o Product Evaluation Comm.: John reports that Mara Kerr and Kevin Madison Co-Chair this committee, both welcome PNCC representation. There is a lack of bedside clinical people on the committee, so PNCC will be of great value to this committee. The committee has been meeting the last Thursday monthly, but will be re-evaluating the monthly meeting day/time for 2010. The PNCC discussed the many products reviewed at the last Eval Committee meeting: IV start kit, Bard straight caths (will be getting house-wide inventory on cath kits), bath mats, Dignicare stool management system, Medline transition, Tegaderm dressing trial, New ambu bags, silver coated urinary catheters. This promises to be a great committee for PNCC representation. o IT/Clinical Educators Committee: John reports that this new committee is chaired by Randall Currier and is comprised of the house wide clinical educators and IT. The goals are to improve relations/communication and come up with better ways to share IT information. At this point there are no bedside clinical staff on the committee with the exception of John. This committee will be meeting weekly for now, and will likely meet less as time goes on. PNCC would like to see this be a long lasting committee with monthly meetings and more acceptance of PNCC representation. o John reports that there are now seven committees that will need PNCC representation. PNCC members have volunteered to be part of these committees. Two PNCC members will represent each committee; the two members can share meeting coverage and reports. (Exception, IT/Clinical Comm. will have one PNCC representative). • Clinical Practice Comm. (Selena/Leanna) • Product Evaluation Comm. (Marie/Dana) • RN/Pharmacy Comm. (Marta/Marie) • IT/Clinical Educators Comm. (John) • McKesson Change Priority (Selena/John) • UPC Chairperson Quarterly (Leanna/Kathy) • Safety Comm. *looking into this* PNCC 2010 meetings: - With some discussion it was concluded that PNCC would meet the first Monday of every month starting February 1st. The meeting will be from 0900-1130. The January meeting will be on Monday January 18th from 0900-1130. John will contact Karyn Glass and have the 2010 meeting schedule established. Other items: - John will communicate to Pam Steinke the PNCC member representatives for the specific Admin committees. - John will communicate with the Admin committee chairs who the PNCC member representatives are and request they are placed on the committee member email list. - PNCC members have agreed to use Kronos for the PNCC meetings and the Admin meetings they attend. The PNCC code for Kronos will be provided to PNCC members. - John to contact Duke to set up a time that PNCC and the Neg Team can meet regarding upcoming contract negotiations. - There was brief discussion of wanting a PNCC section on Caregiver Net. We will look into this further. PNCC 2010 Goals: - These items were identified as possible 2010 goals and will be discussed further in January. o McKesson improvement o Establish new relationships between PNCC and Administration committees. o Education fund changes. o Morale discussion. |
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| 11/23/2009 |
PNCC NOVEMBER MEETING MINUTES |
| PNCC Meeting Minutes Monday Nov. 16th 0930-1200 Attendance: John Nangle, Kathy Phillips, Audrey Hatfield, Karen Stanard, Leanna Leyes, Terri Lewis, Marta Izo, Dana Peters, Selena Smith, Lynda Coats. Welcomed new members and brief discussion on roles that will be voted on at the December meeting: Chair, Co-Chair. Other roles to be filled by volunteer process: Education, SRDF, Secretary, CHC committee liaisons (Nurse/Pharm, Change Comm., New product Comm., IT/RN Comm). Lynda ---Staffing Committee report: She and Co-Chair, Deb Robinson, attended the Statewide Staffing Conf. and did a Productivity Presentation, which can be viewed on the iDrive (located under START menu, and Network). CHC is working on Altered Standards of care for disaster/crisis situations, spelled out in the Disaster Plan. The trigger at this time is >120% productivity. Terri ---SRDF Report: NICU has been experiencing an increase in SRDF/SIR forms in fall 2009: Sept.=4 reports, Oct.=2 reports. These reports are stemming from the charge nurses having to either take patients or assign the NICU Transport RN to an assignment. The NICU Transport RN was not intended to take assignments when this role was established. NICU has National staffing standards. Currently NICU has a core staff of 6: Charge, Transport RN, and 4 RN’s. It may be that they need to be at 7. Lynda will be looking into this issue with the NICU staff. Karen ---Education: We have a large amount of Education Funds left this year. There is great concern regarding the culture of education that seems to be slipping at CHC Bend. RN’s have been too bogged down with the new computer system education. The system has really taken a toll on motivation and RN’s seem to have little room to pursue needed continual education. There will be more discussion on a new strategy for PNCC partnering with our CHC Bend Educators to foster a new culture of education. Kathy, MSVS RN, reports that she is working on using up their Rollover funds on some 2010 conferences. Lynn Iwaniec, SIP MD, dropped in to continue our conversation regarding the need for better communication at CHC Bend. We have been discussing having a Vital Smarts (Critical Conversations) presentation. PNCC will look into ability to fund something like this. Although the discussion focused on RN/MD communication we all agreed that a facility this large with the complexity of issues involved should be house-wide education annually. The plan would be to get it started as a PNCC/SIP collaboration and hopefully CHC would take this over. We will revisit this seriously in the Jan meeting. John reported on the Nurse/Pharm Comm. A sample letter by the RN/Pharm Comm. was reviewed and it was felt that it captured the frustration of RN’s and offered a new direction that was necessary for upholding patient safety. The RN/Pharm team is to meet, with plans to finalize and hopefully sent out the finalized version to Administration this week. Lynda will be reviewing and emailing potential times for the 2010 PNCC meeting schedule to all PNCC members. John will be contacting Sue Davidson to set up a time for her to come over and give the PNCC a presentation and get new member binders. |
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| 10/19/2009 |
PNCC MEETING MINUTES--OCT. 19TH, 2009 |
| PNCC Meeting (Mon) Sept. 19th, 2009 0930-1200 Classroom G Members Present: Vikki Hickman, John Nangle, Kathy Phillips, Terri Lewis, Joe Sack, and Lynda Coats 1) Reports: A) Staffing Committee---Lynda C. provides a draft form of “Altered Standards of Care-Patient Care Considerations for CHC”, which are recommendations for standards of Care during extreme circumstances (such as our current H1N1 influx). Lynda C. provided Pam Steinke CNO, with the recommendations on 10/15 and expects a reply 10/19. Lynda C. also reports that bedside RNs were fully represented after much discussion with unit managers. Lynda C. and Vikki H. will both represent CHC-Bend at the statewide Staffing Conference in Eugene on Nov. 7th, 2009. B) Educational Fund---Karen S. provided a report that Vikki H. read: YTD $65,836 used from the PNCC fund out of $163,000 (which includes the $13,500 carried over from unused funds from last year). Only 59 RNs have used their entire funds. Karen S. has reminders to staff placed in all units. C) SRDF---Terri L. reported that there are a few SRDF forms that she needs to go over before reporting to PNCC. Terri L. stated the hot spots seem to be Family Birthing and OR. Terri L. did report a problem with the staffing office placing staff in areas inappropriately. Lynda C. reports a problem with the staffing office not taking into account the knowledge, skill and responsibility of Charge nurses when staffing their units. John N. will bring the subjects to the house-wide Charge Nurse meeting on Oct. 29th. Lynda C. to take concerns to the Staffing Committee. D) Recommendation to HR on Step increase---Vikki H. reported on the PNCC recommendation for a retroactive step increase for an RN who has been nursing since 1979 and has a lot of clinical experience in varied areas. Vikki H. has been in contact with Al Deluso and should have a decision soon 2) PNCC discussed the possibility of (50) $1,000 fund “scholarships”. There was some concern over whether these funds could be rolled into the next year. Vikki H. will investigate further and write up guidelines for scholarship fund usage. Kathy P. to procure copies of RNs divided up by unit. Potential drawing to be Nov. 16th. 3) Vikki H. reported that she discussed with Dr. Iwaniec, SIP Chief Medical Officer for Redmond, the results of the survey done for the SIP group by PNCC. Suggestions for the SIP group included: Publishing a pamphlet on their goals, group structure, etc., putting up a website, or doing a few presentations. Vikki H. will send her recommendations to Dr. Iwaniec in written form. Cary Pulido could not be present. Vikki H. states that Cary is attempting to start an AACN chapter @ SCMC-Bend. One benefit of an AACN chapter is the opportunity for educational offerings for staff. 4) McKesson: Kathy P. reported on the Pharmacy/Nursing Committee--Re-scheduling of -vs- “catching up” antibiotics, list of antibiotics that Pharmacy has agreed to reschedule, timing of multiple antibiotics at the same time, responsibility for Med/Red transfers are ultimately the physicians (EMS reports have been written about this), viewing of ED reports-vs-printing the report out for admissions, appropriate Override reasons that should be added to the list. John N. reports that he has agreed to be on the McKesson Change Committee, which will deal with issues not RT medications/pharmacy. The Change Committee has not met yet but some issues discussed were: HEC—Admission and history data not populating to HHS, cataloging issues/updates and resolutions. Respectfully submitted---Kathy Phillips, RN MSVS |
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| 7/20/2009 |
PNCC MEETING MINUTES |
| PNCC Meeting Mon) July 20th, 2009 0930-1200 Classroom H Members Present: Vikki Hickman, John Nangle, Kathy Phillips, Terri Lewis, Karen Stanard, Joe Sack Guest: Dr. Lynn Iwaniec 1) Reports: A) Clinical Practice Committee (CPC)--- John N. reported on issues discussed at the CPC: 1) PACU/Presurg supervisor, Joyce Tittle, stated that there may be a change in process around either INTing or changing a patient’s maintenance fluids before being taken down for a procedure. PNCC members stated that an order must be written for either of those things to happen. The possibility of creating an outline in McKesson was put forward. 2) SCMC might be starting use of a new Lantus injection pen. 3) Issues were discussed involving the length of the new suction tubing—CPC is evaluating options. 4) A different brand or style of IV start kit is being evaluated. B) Educational Fund---Karen S. reported: YTD $51,130 used from the PNCC fund out of $163,000 (including the $13,500 carried over from unused funds from last year). A specific case for approval of funds discussed for use of funds for application to a BSN program—PNCC decided to allow use of funds provided applicant could prove admission to the program. The revised WI on PNCC Education funds for SCMC-Bend approved. Education poster to encourage PNCC fund use was sent out over the intranet to all ONA RNs. PNCC discussed the roving picture board and Kathy P. agreed to continue rotating it between units on a monthly basis once Karen S. completed it. Karen S. reported that she would be gone the majority of Sept. and Tiffany F. may not be able to cover during that time-- Karen Stanard will be putting an email out to the committee members asking for volunteers to fill in for the month of Sept. for fund allocation approval. C) Roll Over Fund---Vikki H. reported that no Roll-Over Funds have been used to date this year. Vikki H. reported that fund usage for FBC, MDU and SSC has stalled. MDU was interested in education on the legalities of charting for specific procedures. John N. reported that PCS continues to make arrangements to send 2 RNs to a conference. Kathy P. reported on MSVS’ plans for use of their funds but stated plans are on hold until after GO Live for McKesson. D) SRDF---Terri L. reported that no progress has been made on refining the SRDF spreadsheet. 2) Dr. Iwaniec reported on the reorganization of the SIP group. Dr. Zipper is Chief Medical Officer (incorporating 8 hospitals in the Pacific Northwest). Dr. Watford is now the combined operations chief for SCMC—Bend and Redmond. Dr. Proffit is the co-chief for Bend and Dr. Iwaniec is the co-chief for Redmond. Dr. Iwaniec reported that the SIP group is interested in: A) Feedback from staff on how they feel this new reorganization model is working. B) Increasing communication with nurses and satisfaction with the SIP service while maintaining a high level of quality and patient safety. PNCC felt that education of staff on the new model was needed and agreed to put out an RN survey over the intranet. Survey questions discussed: Do you have any questions regarding the hierarchy, function or number of physicians of the Sound Inpatient Physicians (SIP)? Do you have any questions regarding any aspects of clinical practice, as it relates to SIP? Do you have any questions regarding the relationship between nursing and SIP? Do you have any general questions or concerns you would like addressed with the SIP group? Regarding education—what clinical subjects are you interested in? Karen S. will send the survey out and request that all answers to the survey be forwarded to the PNCC email account. Vikki H. will review the survey results from nursing. Dr. Iwaniec suggested specific education on “A Day in the Life of a Hospitalist”. Vikki H. stated that PNCC was interested in using the carry-over budget of $13,500 for large-scale educational conferences for staff. PNCC requested that Dr. Iwaniec poll the SIP group to see if they are interested in providing education to staff. Dr. Iwaniec suggested a specific program: Vital Smarts—Silence Kills, a program that includes role playing and addresses difficult communication between caregivers. C) SIP is interested in increasing patient satisfaction and community confidence in SCMC-Redmond through repatriating patients back to Redmond as their care needs come into line with the ability of SCMC-Redmond to provide their care. PNCC discussed this and recommended that Dr. Iwaniec meet with the CPC to get feedback and their recommendations on how best to accomplish this. Respectfully submitted---Kathy Phillips, RN MSVS |
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| 6/23/2009 |
PNCC MEETING MINUTES JUNE 15TH, 2009 |
| PNCC Meeting (Mon) June 15th, 2009 0930-1200 Rehab Conf. Rm. Members Present: Vikki Hickman, John Nangle, Kathy Phillips, Terri Lewis 1) Reports: A) Educational Fund---Vikki H. read a report from Karen Stanard.: YTD $43,534 used from the PNCC fund out of $163,000 (including the $13,000 rolled over from unused funds from last year). The revised WI on PNCC Education funds for SCMC-Bend needs final approval from the committee. Kathy P. will email Karen S. to request she send email attachment of revised WI to committee for feedback. PNCC Fund Request Application form (F1829 Revision F) is being placed in document control. Vikki H. to speak w/ Karen S. about education poster to encourage PNCC fund use. B) Clinical Practice Committee (CPC)--- Vikki H. with no issues to report. The next CPC meeting to be held 7/1/09. C) Roll Over Fund---Vikki H. reported that no Roll-Over Funds have been used to date this year. Vikki H. reported that SSC has hit some small snags in proceeding. John N. reported that PCS is progressing on their plans to send 2 RNs, who won PCS’s drawing, to a conference. Kathy P. reports that MSVS should be ready by the end of summer to use their funds and has narrowed the choices down to two options. MSVS’ UPC would be making a decision today on how they would proceed. D) SRDF---Discussion about staffing and patient safety in IMCU. Vikki H. to speak w/ Lynda Coats, Joe Sack and Lusine Sarkisian (IMCU Manager) to better understand how and why IMCU is staffed the way it is. Vikki H. to invite Pam Steinke, Bend CNO, to the July PNCC meeting. John N. to get together with Keryn Glass and Terri L. to work on refining the current SRDF spreadsheet to capture trends. John N. also to work w/ Terri L. on defining the work process for the SRDF Manager and present both at the next PNCC meeting. E) Outreach Position---Vikki H. read an email from Joe Sack with the contractual description of how OHSU’s PNCC and Unit based Nursing Practice Committees work. Included is a recommendation from Alison Hamway to hold off on creation of a formal Outreach Position until negotiations. UPCs are still to be encouraged to involve the PNCC should an issue reach beyond a unit’s individual scope. 2) Green Committee CBL presentation by Mark Petersen on what belongs in a Sharps container, how medical waste/trash is processed versus how Sharps are processed and the cost savings for correctly placing materials in hazardous waste, trash or Sharps containers. PNCC recommended the addition of DC’d intravenous/arterial line disposal. 3) PNCC Charter reviewed briefly---Vikki H. to resend charter to all members. 4) PNCC sponsored conferences/ presentations: PNCC reviewed the contract and discussed the possibility of using the yearly education roll-over funds (currently $13,000) to sponsor conferences and speakers (possibly our own Physicians and RNs with advanced practice knowledge). Any conferences done locally could be taped for those who were unable to attend. Vikki H. will look into these possibilities and present her findings at the next meeting. **Carried over agenda items for next meeting: Review of WI on PNCC Educational funds: Karen S. Results of discussions about staffing and patient safety in IMCU: Vikki H. Work processes for the SRDF Manager: John N. and Terri L. Findings on the possibility of conferences/presentations: Vikki H. Respectfully submitted---Kathy Phillips, RN MSVS |
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| 5/18/2009 |
PNCC MEETING MINUTES--MAY 2009 |
| PNCC Meeting (Mon) May 18th, 2009 0930-1200 Rehab Conf. Rm. Members Present: Vikki Hickman, John Nangle, Karen Stanard, Kathy Phillips, Joe Sack 1) Reports: A)Educational Fund---Karen S. reported that YTD $37,249 used from the PNCC fund out of $163,000 (including the $13,000 rolled over from unused funds from last year). Karen reported that a total of 19 RNs have used all of their funds this year. The revised WI on PNCC Education funds for SCMC-Bend reviewed. Karen S. stated that she felt it needed to include more rules around paying forward into the next year for conference attendance. Karen S. to work on this and email attachment of revised WI to committee for feedback. PNCC Fund Request Application (F1829 Revision F) reviewed and approved. Karen S. presented educational poster, created with assistance from Keryn Glass—Admin. Assistant. Poster approved w/ minor changes and to be distributed via email to Educational Coordinators, UPC chairs, and unit reps to print out for each unit and place in high traffic areas to encourage PNCC fund use. B)Clinical Practice Committee (CPC)---John N. reported on a presentation from a student following Pam Steinke on the poor retention of RNs at SCMC-Bend. John N. stated that a pilot to assess a new document/form to chart on wounds is currently proceeding @ SCMC-Redmond and should be coming to SCMC-Bend soon. When HealthSync begins, labs which are to collected by nursing will have a printed label that goes into the patient’s chart until the nurse can collect it, no decision was made as to who would be responsible for getting the label into the chart at the CPC meeting. John N. reports that real time charting of I/Os for CNAs was discussed and the CPC decided to remove the current I/O sheets used by CNAs to keep a running tally. It was felt that that would encourage CNAs to chart I/Os as they go. PNCC discussed this—John N. and Vikki H. to provide the CPC with a recommendation on objectives. John N. stated a new WI on Guns/Drugs previewed at the CPC. C)Roll Over Fund---Vikki H. reported that no Roll-Over Funds have been used to date this year. D)UPC Chair Meeting---Kathy P. reported that there was a little push back in regards to the PNCC/UPC Liaison description. A paragraph within the description asking for action from the UPCs was not part of a job description. This paragraph will be taken out. The question of whether there should be contract language changes related to the PNCC/UPC relationship will be discussed with ONA labor leadership. E)SRDF---PNCC discussed the purpose of the SRDF forms and John N. agreed to get together with Terri Lewis to develop guidelines for tracking problems/trends evident in the SRDF forms. The group also felt it might be useful to the UPC chairs to receive copies of these forms so they could be aware of problems/trends on their units. 2) Cost Saving Idea Proposals: As a group the PNCC decided that the committee wasn’t the correct forum for this. PNCC Info Sheet: Kathy P. presented the revised info sheet. Kathy P. to send an attachment of the finalized sheet to the committee after making the approved correction. Karen S. and Tiffany F. will be responsible for getting the sheets distributed with each education fund approval notice. 3) Green Committee: Vikki H. stated that the LEAN approach would have a “green” component to projects that are done. The LEAN work group will be using a set of operational concepts that helps drive efficiency through employee empowerment and change at the grass roots. The PNCC decided to hold off on a Green Liaison position until it could be determined how LEAN would affect the Green Committee within the hospital structure. **Carried over agenda items for next meeting: PNCC educational Outreach: Joe S. Review of WI on PNCC Educational funds: Karen S. Recommendations on I/O recording: Vikki H. and John N. Guidelines for SRDF forms: John N. and Terri L. Respectfully submitted---Kathy Phillips, RN MSV |
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| 4/30/2009 |
PNCC MEETING MINUTES FOR APRIL |
| PNCC Meeting (Mon) April 20th, 2009 0930-1200 Rehab Conf. Rm. Members Present: Vikki Hickman, John Nangle, Terri Lewis, Karen Stanard, Lynda Coats, Kathy Phillips, Joe Sack, Tiffany Fredericks Guest: Dr. Lynn Iwaniec Agenda Item #1 --- Monthly reports: A)Staffing committee (Lynda C. reports)—All units seem to be doing well keeping within their budgeted hours with the exception of lack of coverage due to C1:1s. Many units have national nursing standards through their professional organizations which provide safe nursing guidelines i.e. FBC, MDU, IMCU, CCU and Cardiac services. Joe S. states that IMCU is going to a 12hr staffing model starting in Sept which will be piloted for 3 months and then reevaluated. PCS (patient care support) and RRT (rapid response team) are to get their own budgeted hours instead of having their hours spread out among the units. Committee discussed staffing in the units. Vikki and John to go to the Staffing Committee May 12th where Lynda will review the staffing plan in its entirety and the WI on staffing philosophy. B)Educational Fund (Tiffany F. and Karen S. report)--- The revised WI on PNCC Education funds for SCMC-Bend presented. All members provided with a copy which they are to review and discuss at our next meeting. YTD only $29,000 used from the PNCC fund out of $150,000 (not including the $13,000 rolled over from unused funds from last year). Karen S., with assistance from Vikki H., to create educational posters, formatted to an 8X11 size, that can distributed via email to Educational Coordinators, UPC chairs, and unit reps to print out for each unit and place in high traffic areas that encourage PNCC fund use and can be updated, possibly monthly, with the percentage of funds used. C)SRDF forms (Terri L. reports)--- Report on all SIR/SRDF forms turned in from Jan-March 2009. Total reports were: Jan. (6), Feb.(9), Mar. (6)----YTD 21. One specific report from ICU reviewed and discussed. Terri states that in most reports it’s not a matter of how many staff members there are on a unit but how the staff members are utilized that makes the difference. Agenda Item #2 --- PNCC Outreach Education about SRDF: Terri L. to go to the ONA Open Forum meeting Mar. 22nd to talk with staff about how and why to fill out the SIR and SRDF forms. Kathy P. to take over between 1630 and 1930. Education about function of PNCC: Vikki H. presents an informational sheet to be attached to each approval of funds; committee to read and discuss at next meeting. Joe S. and Kathy P. to meet and discuss options for further educational opportunities involving the UPCs. Kathy P. to go to the UPC chair meeting on May 30th and reiterate info given at last UPC chair meeting. Kathy P. to get names of all active UPC chairs and ask those chairs present for their meeting schedules. Guest ---Dr. Lynn Iwaniec (SIP Hospitalist Group) Dr. Iwaniec explained the make up of the teams for the SIP group for both SCMC-Bend and SCMC-Redmond. Dr. Proffit is Chief for SCMC-Bend, and Dr. Watford is Chief for SCMC-Redmond. Their group is working on quality issues i.e. time to diagnoses, time to disposition, etc. One of their main issues is which unit to see first because a bottleneck in one unit creates problems with admits, transfers and discharges in other units. The PNCC discussed this and Dr. Iwaniec felt that maybe their group should go through the House Supervisor to get info on which unit to visit first. She will take this idea back to her group. Agenda Item #3--- Cost Saving Ideas for future presentation to Pam Steinke John N. presented printed info on his idea to cut down on waste involving the paper towel dispensers by replacing the current dispensers with more efficient ones. The committee felt he would need more info—potential savings by replacing the current dispensers versus the cost of each type of dispenser. John would also have to go through the Product Approval Committee on the possibility of a pilot program. John N. presented his idea for a Green Committee Liaison. Job description presented and John N. states he would be willing to take this on. Committee is to read and discuss at next meeting. Terri L. presented her idea regarding savings by eliminating the salt water fish tanks outside of ICU. Terri L. encouraged to write up a proposal. Terri L. presented idea to save money by discouraging staff from using scrubs who are not approved to use hospital provided scrubs. Committee discussed and Kathy P. commented that there was a nursing magazine article of a study that linked rising rates of MRSA within the community to the practice of wearing scrubs into and out of hospitals. An idea was discussed to require all staff to use hospital scrubs or to require all staff to come to work in street clothes, change into scrubs and then go home in street clothes. If a staff member then wanted to use hospital scrubs and have their scrubs laundered by the hospital supplier they could pay a small fee, unless hospital policy required a staff member to use hospital provided scrubs i.e. in OR. Karen S. presented her idea regarding the use of multi-dose vials. Karen S. to get additional information from pharmacy on the viability and possible cost savings of using smaller multi-dose vials. Vikki H. presented a printed explanation of her idea regarding possible cost savings using BMI as a determinant for tiered Health Care Insurance coverage at our last meeting. Cost saving presentations tabled and all committee members encouraged to finish getting their information together and written up to discuss at our next meeting. Agenda Item #4--- Open Discussion It was felt by the committee that the PNCC should be represented at the Clinical Practice Committee. Vikki H. will attend these meeting held the 1st Wed of each month with John N. as an alternate. Summer retreat discussed. Date set for Aug. 17th –3pm at Vikki Hickman’s house for a Tex-Mex potluck. _________________________________________________ **Carried over agenda items for next meeting: PNCC educational Outreach: Terri L., Joe S. and Kathy P. Discuss reviewed WI on PNCC Educational funds Presentation of educational poster on PNCC funds: Karen S. and Vikki H. Discuss reviewed job description for Green Committee Liaison Presentation of write ups and further discussion of cost saving ideas |
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| 3/22/2009 |
PNCC MEETING MINUTES 3-16-09 |
| Professional Nursing Care Committee Meeting Minutes March 16,2009 0930-1200 Members Present: Karen Stanard (RN ED), Terri Lewis (RN CCU), John Nangle (RN RRT) Kathy Phillips (RN MSVS), Joe Sack (RN IMCU), Tiffany Fredericks (RN FBC), Vikki Hickmann (RN ED) 1) Staffing committee report unavailable. Report regarding the unsafe staffing forms as reported by Terri Lewis RN was that there were very few in the past months. There was concern that there is an educational deficit with R’s as to why and how to access the forms. Terri will research and plan an educational offering sponsored by the PNCC to eliminate this deficit. She will report back in April meeting. Reported via Vikki Hickmann that the ETOH withdrawal protocol is on schedule to be active after the Grand Rounds in May 2009. Educational Fund mangers (Karen and Tiffany) presented a rough draft of the new work instruction. A few suggestions were made for changes by committee, but otherwise approved. (Strong work!). A suggestion was made to increase knowledge of RN’s regarding the overall function of the PNCC. This idea was to attach a summary of this information to the returned completed application. The thought was to have the administrative assistant perform this task. Vikki will write a brief summary of this and send to members for critique. 2) Kathy Phillips was the PNCC rep at the UPC chair meeting. She presented the purpose of PNCC as stated in the charter. She also gave the informational packets relating to the roll over fund application process to the eligible UPC chairs for 2009. She also presented the most recent job descriptions of PNCC members and described how the PNCC/UPC liaison would function. Kathy also spoke with UPC chairs about the process of bringing an issue to the PNCC. (Thanks Kathy! Good work!!) 3) Cost saving ideas were discussed. The discussion was informal. It was decided that each member should write up their ideas formally and present them at the April meeting. At that time the presentations that are chosen by the members will be presented to Pam Steinke RN, CNO, who will be invited to the May meeting. 4) John Nangle presented the Formal Consensus power point again for those who missed it. Discussion centered around clarification and understanding of the process. It was decided that the basic principles and group dynamic broad concepts would be added to the PNCC charter under “Roles and Responsibilities” section. 5) Suggestions were made how to incorporate the new job descriptions and formal consensus guidelines into the updated charter. Vikki will do this and send it out to the members for approval. Respectfully submitted, Vikki Hickmann RN, BSN, CEN, PNCC Chair |
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| 3/18/2009 |
PNCC MEETING MINUTES 2-16-09 |
| Professional Nursing Care Committee Meeting Minutes February 16, 2009 0930-1200 Members Present: John Nangle (Float RN/ RRT), Lynda Coats (O/N RN), Kathy Phillips (MSVS/ RN), Terri Lewis (CCU/RN), Joe Sack (IMCU/RN), Tiffany Fredericks (FBC/RN), Vikki Hickmann (ED/RN) 1) Staffing Committee report from Lynda Coats, stating that charge nurses will begin to have regular meetings to increase efficiency in staffing units. Staffing Committee members will be given ability to look at staffing through out the hospital to view and assess any potential discrepancies with call off etc. The ETOH protocol staffing plans were decided to keep status quo with MSVS allowing for some hours of 1:1 for assessment of higher levels on the CIWA score, with other units maintaining their present staffing and having other RN’s on the unit “pick up the slack” as needed. Terri Lewis stated there have only been “a few” SRDF filled out in the past 2 months. Vikki Hickmann reported on the ETOH protocol revision process. The plan is to move forward with the CBL and testing and to have this data presented at the unit meetings. On going education of medical staff with forum for physicians. The transitions are being made for EMR Cerner and McKesson applications. The next meeting will discuss measurement tools to gauge improvement and efficacy of the new process; also will determine who will monitor these measurements and tabulate data. The PNCC has determined that the process is moving forward and that this committee can step back. The original objectives / recommendations presented to the Clinical Practice Committee (June, July-2008): a) If treatment cannot allow safety for pts per protocol are other measures being implemented in a timely manner i.e. call to physician for possible bedside evaluation and/or transfer to another unit? b) Evaluate how often are these pts being transferred to another unit (CCU) for respiratory depression with or without need for intubations c) What is the continuing education for the Alcohol Withdrawal protocol? d) How many of these pts are admitted to the hospital per month on average? 1) Current work instruction and/or standard of care 2) Changes in process for charting scoring of severity of withdrawal 3) Yearly education and/or updates with the ETOH withdrawal process; gathering data for measurable outcome tracking 4) Comparative analysis of the present system and of the new system that may render results for improved pt. care 5) Focus group to research these recommendations The PNCC believes these recommendations have been met or are in a developed state of forward progress to expect successful resolution. The process working with the Clinical Practice Committee is believed to have been a successful liaison promoting improvement of professional nursing practice and patient care/safety. The PNCC hopes to have more collaborative efforts such as this in the future. 2) The educational fund managers are presently evaluating and improving the present application form for PNCC funds for pre-payment, reimbursement and/or wage reimbursement. They are also re-writing the work instruction for PNCC/RN Contractual Education Funds-Bend RN. The PNCC believes it would clarify matters if the PNCC contractual fund WI and the funds for BSN/MSN and Certifications were separated. As these are 2 separate funding accounts. We hope to decrease confusion many RN’s have regarding where to send different types of educational funding requests. There are other suggestions and changes being considered or being put into place for the WI and the application form for the PNCC educational fund. Any changes will be updated at the March meeting. Rollover funds for 20009 are available. There are a few process changes this year. Vikki Hickmann will be the first line liaison with the UPC’s to facilitate fund usage. The other part of the process will remain the same. We hope to decrease some confusion with this change. Please be sure and fill out the monthly “PNCC Work Hours Form” and email to John Nangle. This is very important that we document the number of hours utilized and what type of work was done during those hours. We want an accurate accounting of how much time the PNCC needs to perform it’s contractual obligations. Mary Ann Kruse came to the PNCC to present an issue regarding change in practice of fund allocation. Mary Ann states that she has been in the practice of getting her RN License renewal paid for by the PNCC and that she has been able to (in the past) receive payment for CEU’s performed in the previous year with funds form the present year. This year (2009) she was denied 2009 funds for 2008 CEU’s. She had used all of the $600 for 2008 requests. She was stating that there should have been some sort of warning before denying her requests and not just an abrupt change in past practice. The PNCC decided that there had been a mistake in this past practice of paying for an RN license and funding past CEU’s with present funds. The PNCC decided unanimously that these mistakes cannot be repeated and will not continue. Solution to this confusion will be to update and clarify the present work instruction and application form (presently in progress). We would like to thank Mary Ann for taking the time to bring this to the PNCC’s attention and taking time out of her busy schedule to come to the meeting. The PNCC also invited Mary Ann and/or others from the OR/PACU/Pre-surg/Pre-admit area to join the PNCC if they are interested. These areas represent many RN’s and having representation from that area may improve communication. 3) Request for approval of job description for the PNCC charter was approved. This includes: UPC Liaison **The PNCC is looking into cost savings as it relates to our clinical practice. The PNCC would like to be proactive with the financial challenges, and may recommend some clinical practice changes after weighing the ideas proposed. PNCC members will be coming up with some ideas to discuss at the next meeting. Respectfully submitted, Vikki Hickmann RN, PNCC Chair . |
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| 3/18/2009 |
HOW TO BRING AN ISSUE TO THE PNCC |
| How to Bring an Issue to the PNCC ➢ Is the PNCC the appropriate committee to bring your concerns/issue to? Does it have the authority to evaluate / resolve the issue? ➢ ➢ Have the request/ issue formulated in a concise, clearly written format. There will be forms on each unit in the “ONA notebook” titled “PNCC practice issue request for review”. One may use this form or write out the issue without using the form. ➢ This needs to be presented to the chair at the time of the request to be placed on the agenda. ➢ Request to be placed on the agenda at least 2 weeks (if possible) before the next PNCC monthly meeting. Email vikhic@gmail.com. The PNCC will hear two 15-minute presentations at the beginning of the monthly meeting. ➢ The PNCC will take your issue into consideration and discuss it in committee. Please be prepared to thoroughly answer questions the PNCC has during the 15-minute presentation. You may be asked to respond back at a later date if there is a time constraint or insufficient information on your issue ➢ The committee will have other guests at the meeting other than the first 30 minutes by invitation only. ➢ The rationales for these stipulations are due to the short tie we have to work on the business of the PNCC and to promote clarity of communication. We feel this will facilitate efficiency in time management for all parties involved. |
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| 1/27/2009 |
PNCC MEETING MINUTES 1-19-09 |
| Professional Nursing Care Committee Meeting Minutes January 19,2009 0930-1200 Members Present: Lynda Coats RN (O/N), John Nangle RN ( RRT/RN), Joe Sack RN ( IMCU), Kathy Phillips RN (MSVS), Vikki Hickmann RN (ED) 1) John Nangle gave a presentation on “Consensus Based Decision Making.” The power point outlined the process the PNCC is evolving toward in making decisions. Some of the main points were: Add principles into the charter Non-violent communication Phases of consensus Pre meeting check in for approximately 2 minutes “The individual is responsible for expressing concerns; the group is responsible for resolving them. The group decides whether a concern is legitimate; the individual decides whether to block of stand aside.” The PNCC will gradually incorporate these principles into operation and evaluate the effectiveness on decision-making process. . 2) Joe and Kathy presented potential items for the UPC Liaison job descriptions: 1) Receive UPC’s mtg minutes 2) Attend quarterly UPC meetings 3) Obtain an updated list of UPC chairs 4) Facilitates communication between UPC and PNCC 5) Kathy and Joe will develop a new name for this position that combines this with the new hire orientation piece Practice issue facilitator job description accepted How to bring a process to PNCC accepted. Joe Sack will present this information to the UPC chairs and give associated information. 3) Staffing Committee report: IMCU out of budget d/t etoh withdrawal 1:1 Not all units use budget in for RN 1:1, so they run a variance at those times. Medical has a certain amount of RN 1:1 built into their budget. ETOH review: physician groups approve the protocol. The next meeting 1-23 Friday will discuss some final points, including education of staff and implementation dates. There will also be a sub-committee of the hospital staffing committee, which will look at standardization of care per patient need for alcohol withdrawal. There will be a meeting 2-2-09 to evaluate the function and efficiency of the administrative assistant for 2008. This is the first full year the PNCC has used an administrative assistant that is not a PNCC member. 4) Lynda Coats will be taking on the Pharmacy issue, regarding moving responsibility of mixing some medications from pharmacy to Nursing. She will be the issue facilitator, and will request help from other PNCC members as she needs. This issue is in the information gathering phase. Respectfully submitted, Vikki Hickmann RN, PNCC Chair |
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| 1/4/2009 |
PNCC 12-22-08 MEETING MINUTES |
| Professional Nursing Care Committee Meeting Minutes December 22, 2008 0730-1000 Members Present: John Nangle (RRT-RN) Karen Stanard (RN-ED), Lynda Coats (RN-O/N) , Tiffany Fredericks (RN-FBC), Joe Sack (RN-IMCU) , Terri Lewis,(RN-CCU) Vikki Hickmann (RN-ED) Guests: Alison Hamway ONA, Pam Steinke RN, CNO 1) The Staffing Committee has not met for a month and will not be meeting until January 2009; no updates available. The Education Fund Managers at this time have the total general fund expenditure at $113,436 out of the total fund of $ 135,000. The PNCC is allowed to carry over 10% by contract. With $21,564 unspent fund and $13,500 carry over, that leaves $8064 of educational fund back to St Charles general funds. In the roll over fund for 2007, of $14,720, there has been $13,050 spent. This leaves $1670. These are all preliminary figures according to the administrative assistants spreadsheet. The fund managers will be comparing the hard copy accounting with this and give the final numbers to the PNCC in January. The Education Fund Managers will be working on re-writing the work instruction for accessing PNCC educational funds. Some of the goals that will be included are: 1) Separate PNCC expenditure with MSN/BSN certification reimbursement/payment 2) Specific job description for the administrative assistant 3) Re-write /adjust roll over fund instructions 4) Re-write application form 5) System for nurses to access amount of individual fund usage. These changes will be presented at the February meeting. The committee work involving revision of the Alcohol Withdrawal policy is moving along. The last meeting was 12-5-08. The PNCC made further recommendations to the ETOH committee. In keeping with the objectives of improving patient care and optimizing safety for Nursing staff and patients the PNCC has recommended closer monitoring of vital signs and severity scoring when patients require on going medication dosing; an easily accessible work instruction and/or standard of care via the EMR; specific parameters to call a physician and consider transfer to a higher level of care; and staffing determinations in association with specific acuity and intensity ratings of the withdrawal patient. The meeting for 12-19 was cancelled and the next meeting will be in January. The hospital Staffing Committee will be involved in specific unit staffing models in relation to the new policy. 2) John Nangle discussed “ Formal Consensus” process for the PNCC. He handed out information. The committee will read through the information and in January John will give a presentation and the committee will have discussion and attempt to come to a decision of formalizing and putting into practice this new process. John created a new template for time keeping of PNCC hours worked and specifics about type of work performed. Each member will fill this out monthly and email to John. 3) Job descriptions for the PNCC charter were discussed. The UPC liaison will be presented in January. The Practice Issue Facilitator job description was approved. The process for this job description could not be approved in the time frame allowed. The committee will study it further and work toward approval in January. The revision of the document “ How to bring an issue to the PNCC” will also require further study and will be revisited in January 2009. Lynda Coats will present in January an example of a “template” for people to fill out for the issue. 4) Pam Steinke RN, CNO attended part of the meeting. Discussion surrounding the PNCC member who is the UPC liaison (Joe Sack RN) regarding having quarterly meetings with the UPC chairs. Pam verbalized that there are benefits to a UPC/PNCC linkage. Discussion included possibly using some hours where nursing is being called off, that some could be used for committee work. 5) Pam stated that she would update lists of UPC chairs to help facilitate notification for meetings; re-evaluate UPC charter. Pam also stated her belief in work place stability. She believes that “best place to work is the best place for patients.” Pam also stated that the model of a CNO for each facility (Bend, Redmond, Prineville) is working out very well. The three CNO’s meet every 2 weeks. Discussion regarding the EMR implementation occurred. There is now a Clinical Specialty Implementation Team dealing with the interface between the technology and the direct care of patients. The team is meeting with McKesson periodically and giving input as to what changes may need to occur to facilitate efficient, quality, safe patient care. Respectfully submitted, Vikki Hickmann RN PNCC Chair |
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| 11/23/2008 |
PNCC MEETING MINUTES 11-17-2008 |
| Professional Nursing Care Committee Meeting Minutes November 17,2008 0730-1000 Members Present: Vikki Hickmann RN, ED; Lynda Coates RN, O/N; Terri Lewis RN,CCU; John Nangle RN,Float; Kathy Phillips RN,MSVS; Joe Sack RN,IMCU; Tiffany Fredericks RN,FBC; with new members- Kathy Stumpfig RN, Radiology; Marsha Noone RN, O/N; Rick Miller RN, ED 1) Lynda Coates gave update on Staffing Committee seminar. Lynda gave background to the new members with historical view of the evolution of the staffing law and the committee. Tiffany Fredericks gave update on educational fund expenditures: balance in the main fund was - $ 44,161.24; balance in the roll over fund was- $ 6,931. The units that will utilize the roll-over funds for 2009 via their UPC’s are: medical floor= 68=$ 4624; on-call/float=27=$ 1836; medical diagnostics=19= $ 1292; family birthing=54= $ 3672; surgical=45=$ 3060; wound=7= $ 476 This equals 220 RN’s with fund resource of $ 14,960. These totals are arrived at by $ 68 per RN allocation. ETOH revision is progressing along. Most of the physician orders and protocols are written. We are at the time of writing the Standards of Care (SOC) and Work Instructions (WI). This is a critical time that the PNCC needs to make sure we represent the bedside RN and present arguments that support efficiency and accessibility of all this information to the bedside RN for standardization of care and educational purposes. John Nangle will be representing the PNCC/RN’s at the next meeting on Nov 21. 2) Joe Sack represented RN’s to promote limitations on report during specific times at change of shift. Joe went to the unit manager’s meeting presented the proposal to limit transfer of new patients during 1845 to 1905. The argument was one of accuracy /efficiency in giving pt report to the nurse who will be taking that pt and not the off going RN who will not be giving much care if any to that pt. All units agreed to perform this change. Joe will be helping to write the work instruction for this policy The PNCC Charter is in the process of being revised per suggestions given at the October retreat. The UPC Liaison job description will be written by Joe Sack and Kathy Phillips and presented at the Dec. meeting. John Nangle will write the overall Practice Issue Facilitator job description with the specific process steps written by Vikki Hickmann. This will also be presented to the committee at the Dec meeting. If these are written up by the time the Dec agenda goes out to the committee, the rough drafts will be attached. 3) Pam Steinke was unable to attend the Nov. meeting; she will be invited for the Dec. meeting. 4) The decision making process by consensus will be revisited at the Dec meeting. Please review the link sent with the November agenda. We will hopefully get to discuss further and practice using this process with the 2 new charter job descriptions at the Dec. meeting. Throughout this meeting there was background information given to the 3 new members with explanations of history and evolutionary process of the PNCC over the past 3 to 4 years. The meeting dates, times and locations for 2009 were planned. Keryn Glass has printed up this schedule and has arranged the meeting locations. It will be attached to the minutes. Respectfully submitted, Vikki Hickmann RN PNCC Chair |
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| 10/10/2008 |
PNCC 9-29-08 MEETING MINUTES |
| Professional Nursing care Committee Meeting Minutes September 29, 2008 0730-1000 Members Present: John Nangle, Kthy Phillips, Lynda Coats, Karen Stanard, Terri Lewis, Joe Sack, Vikki Hickmann Guests: Alison Hamway ONA, Keryn Glass PNCC education fund assistant 1) Updated report of the Hospital Staffing Comm. given per co-chair Lynda Coats RN. The hours per pt day are up. The committee has been waiting for data from Labor Management Institute to help with the budget making process possibly, but the information will at least help SCMC-B with comparisons of variables of like hospitals and those variations that contribute to the unique needs of SCMC-B. There are some differences that will need to be addressed in the staffing models, such as length of stay. SCMC ave. length of stay (LOS) is 3 days, versus the nation wide average LOS is 4.6 to 4.8 This difference greatly impacts the intensity of the care for patients. 2) A wide varied discussion took place regarding the transition of the EMR from Cerner to McKesson. PNCC has concerns as to how many extra Nursing hours will be allocated to training and “go live.” There were also concerns regarding the physician training interface issue. If physicians have difficulties entering orders this directly impacts nursing time and therefore directly impacts patient care, safety and outcomes. (As of the writing of these minutes, the decision has been made to put a hold on go live with McKesson. The PNCC agrees with this decision and hopefully this will give the needed time for an orderly training and transition period to the new EMR) 3) There has been some concern in the PNCC regarding the individual UPC’s who were able to spend some of the roll over funds for their specific unit’s education. Not much of the approximate $14,000 has been spent. To date there is $13,550 left. Some UPC’s voiced concerns that they did not want to spend their own personal money to buy for example books, and then wait for the reimbursement process. Keryn Glass was invited to attend the meeting to collaborate on how to facilitate the process of UPC fund utilization. Keryn informed the committee that the standard form for requesting pre-payment for items such as books could not be used and that accounting would not prepay for any items such as books, or other educational materials. Karen Stanard and Terri Lewis, PNCC members stated that they would pay for the materials and then fill out the appropriate paperwork for reimbursement. (since the 9-2-08 meeting , Keryn Glass has researched this process and states that the UPC’s may be able to use a non-inventory requisition for purchasing these items and use the PNCC cost expense code.) The PNCC is committed to helping facilitate the use of these roll over funds in a timely manner, as the UPC’s will lose the funds if not requested by December 15th. 4) An update was given by Vikki Hickmann regarding the process of creating a new Alcohol Withdrawal Process. To date the multidisciplinary committee has decided upon using the Clinical Institute Withdrawal Assessment of Alcohol Scale- Revised (CIWA-Ar). It was also decided to continue with the present questions on admission regarding alcohol use, add in the question “have you had a drink in the past 7 days?” and then move onto “CAGE” questions. If 2 of the 4 questions are answered affirmative then the RN does a CIWA and calls the MD for orders. There was also a tentative decision made to follow a recommended prophylactic medical pathway and from the level of 4 affirmative answers to “CAGE” down to 2 affirmative answers to “CAGE.” These are tentative as internal medicine was not present at this particular meeting and it will need to be run by them. (As of this writing there was another meeting of the committee on Oct 3. I was not able to attend as I was working and had no coverage. My concerns regarding a pathway for RN’s to follow considering specific patient symptoms, to require a bedside evaluation by an MD, were given to the chair Karen McGuire to present to the committee in my absence.) There was also some concern from PNCC members that if MD’s wanted to allow pts to have alcohol to drink with their meals when they are admitted to the hospital for a procedure, that this practice will not be over ruled by the new AWS procedure. . There was some discussion regarding the Acuity Survey presentation at the Labor Management Committee meeting. Generally this changed focus to concern about the change in management structure and the leaving of CNO Jane Hanson. It was decided to have a meeting with the Negotiating Team, Chair of Staffing Comm and PNCC Chair to decide a plan to address these changes in a coordinated effort. 5) A date was set for the PNCC retreat , November 20,2008, 1000 to 1400. Respectfully submitted, Vikki Hickmann |
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| 8/31/2008 |
PNCC 8-25-2008 MEETING MINUTES |
| Professional Nursing Care Committee Meeting Minutes August 25, 2008 0730-1000 Members Present: John Nangle RN, Kathy Phillips RN MSVS, Vikki Hickmann RN ED, Joe Sack RN IMCU, Terri Lewis RN CCU Guests: Lynda Coats RN O/N, Chair hospital staffing comm. Jane Hanson CNO Cascade Health Care 1) After investigation of staffing changes in the Cardiac Rehab unit by the PNCC and Lynda Coats from the staffing committee, it was recommended that the unit go ahead with the hiring of the masters prepared exercise physiologist. This will help grow the program and then as needed another RN may be hired. The PNCC would like to thank Denise Born RN from the Cardiac Rehab unit for providing invaluable information and all the background data needed for a decision to be made in a logical, educated manner. The PNCC would also like to thank Lynda Coats for contacting HR and for the cooperation from HR to work collaboratively with staffing committee on issues that deal specifically with Nurse staffing changes. Lynda gave update regarding the hospital staffing committee and state wide staffing committee. A state wide staffing committee conference is planned for November 6, 2008 in Salem. There will be info coming to everyone one via email soon. There will be speakers present from SCMC. The hospital staffing committee will be looking at “hours per pt day” and there will be an update from the financial office at SCMC regarding the “case mix index”. This may facilitate some changes in staffing. The new software is being incorporated and the financial aspect of staffing is being analyzed and some of this new information will be forth coming at the next staffing comm. meeting, which is Sept 9, 2008. Regarding update on Article 8.3 in the contract for credit for prior experience: Angela Auel was awarded retroactive pay for prior experience from the time she started taking call to present. She was awarded to the 9th step and given credit as being in her 10th year of seniority. Regarding update with Clinical Practice Comm.: specifically in regards to review of ETOH withdrawal protocol, Vikki Hickmann will sit on a multidisciplinary work group of 11 members to review the present practice and make changes as needed. Joe Sack will be the UPC chair liaison with the PNCC. Terri Lewis continuing to track SRDF and SIR forms. Terri expressed how there seems to be several that indicate the Staffing Office being at fault for short staffing a unit. This needs to be tracked so it does not cloud our data for short staffing due to hours per pt. day. Two very separate issues. 2) John Nangle reported that Karen McGuire is looking into staffing the infusion room issue. At present in the “off” times when there is no specific staff assigned, the surgical floor charge nurse staffs this area. These hours are not budgeted in at present; therefore it is a drain on the surgical floor nursing hours. There is apparently no work instruction or job description for this either. Staffing Comm. will follow up on the staffing piece. John, Vikki and Lynda worked together on the 28th and complied data regarding the staffing survey sent out to all RN’s at SCMC. Lynda at the Sep 9,2008 staffing comm. meeting will present this information. 3) Jane Hanson CNO came to the meeting. There was discussion stating that the house wide SHARQ format report form is in place and in use as of the 25th of August. There is also in use pre-printed care plans by nursing diagnosis with interventions and outcomes. Discussion about nurses being able to access their personal lab work was clarified that the nurse just needs to go to medical records and they will print it out for them. Jane also shared her thoughts on what PNCC meant to her and it’s importance and relevance. She would like to see the UPC and PNCC connected somehow. She encouraged the PNCC to begin regularly attending the Clinical Practice Comm. and the quarterly UPC chair meeting as a way of staying in tune with more clinical issues. The issue of being able to leave work and have pt care coverage is always a hindrance to having nurses attend these meetings. She stated understanding and will speak with the unit managers regarding this issue. 4) The Oct PNCC meeting will be cancelled and the retreat will take it’s place. The retreat will be Oct 23, 2008 from 0900-1400 Thursday at Vikki Hickmann’s house. Agenda will follow. Meeting adjourned 1000 Respectfully submitted, Vikki Hickmann RN PNCC Chair |
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| 7/3/2008 |
PNCC MEETING MINUTES JUNE 16,2008 |
| Professional Nursing Care Committee Meeting Minutes June 16, 2008 0730-0900 Members present: John Nangle, Teri Lewis, Kathy Phillips, Tiffany Frederick, Joe Sack, and Vikki Hickmann Guests: Lynda Coats, (RN 0rtho/neuro staffing comm. Chair), Denise Borne (RN Cardiac Rehab) 1) Discussion was heard regarding potential changes in Cardiac rehab as to their staffing of licensed RN’s to other personnel. Concerns were issued as to whether the RN would be able to fulfill their professional responsibilities if the RN staff was decreased. Discussions around national staffing guidelines in this specialty were considered and the question of whether the hospital wants to meet those standards or not. Lynda Coats from staffing committee was present and will speak with the other members on the state staffing committee about this issue. The PNCC asked to have copies of the job descriptions of staff in the Cardiac rehab unit, evaluation tools, copies of the national standards, program description as it is presented to patients and families and a summary of how other cardiac rehab units in the state are staffing. Once this data is compiled, this information will be shared with the hospital staffing committee and will be presented at the Clinical Practice Committee as needed. Vikki Hickmann will be working with Denise Borne on evaluating the data and presenting argument, as needed to support safe patient care and support RN professional practice. 20 Lynda Coats was unavailable to give update on Staffing Committee as she had other responsibilities. Terri Lewis gave update on staffing incident reports through April 2008. Overall nurses are filling out for April, staffing incident reports (hospital form) to staffing request documentation forms (ONA form) 4:1 ratio. Terri has been acknowledging receipt of ONA form to specific nurses, but will now also acknowledge filling out the hospital form. Tiffany Fredericks stated the amount of educational funds used to this date was approximately $50,000. The budget is $135,000 for 2008. Requests for funds usually peak in the fall and continue to rise until the end of the year or until the funds run out. There has been no other request for additional roll over funds made from other units UPC’s beside the usage by ICU at this time. Other agenda items were not discussed and meeting adjourned at 0900, Respectfully submitted, Vikki Hickmann RN PNCC Chair |
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| 5/20/2008 |
PNCC MAY 12, 2008 MEETING MINUTES |
| Professional Nursing Care Committee Meeting Minutes May 12, 2008 0730-1000 Members present: Anne Coleman, Kathy Phillips, Tiffany Fredericks, Terri Lewis, Joe Sack, John Nangle, and Vikki Hickmann Guests: Jane Hanson, Alison Hamway General discussion of staffing changes in various units related to budgetary needs. Changes in practice of traveler usage and CNA 1:1. This was to bring members unaware of changes up to speed. 1) Terri will in the June meeting bring the committee up to date on SRDF usage and hospital staffing incident reports. She will consult with ONA regarding the use of their new spreadsheet and report to committee in June. 2) Jane Hanson CNO for Cascade healthcare invited to attend PNCC quarterly meeting. Specifically the committee was curious regarding effects on direct care nursing practice with staffing changes. Committee members voiced concern of unilateral changes in skill mix; changes in hours per patient day assigned to acuity levels. Specific units were given as examples. The PNCC brought up the issue that this might run contrary to the staffing law. Jane assured the PNCC that she was in favor of a team effort specifically as it relates to the hospital Staffing Committee to assess, plan, implement and re-evaluate matters of direct patient care staffing. The question was asked, “is the intensity of the patient reflected in the staffing?” This was not specifically answered. The Leader Management Institute was cited to have some information on this, but was not discussed at length to gain understanding on this subject. The discussion also posed the question as to how has the use of the Electronic Medical Record (EMR) impacted the intensity and hours per patient day of overall patient care. Jane did say she was for dong a time study to try and obtain some objective data to answer this question. Jane also stated that she is trying to support the management team in promoting American Organization of Nurse Executives (AONE) standards. She also stated that she is beginning work with the various departmental Directors to promote AACN leadership standards. Another issue of nursing practice was discussed. It was stated that some nurses thought the Alcohol Withdrawal Procedure might need to be evaluated. Terri Lewis and John Nangle wondered if there were many patients requiring intubation and/or transfer to the ICU. Questions were raised surrounding the amount of staffing support direct care nurses were allotted with this type of patient. Did they have time to do the potential q 30 min. assessments? Was patient safety compromised in any way? Did the charting reflect the intensity of care? Terri Lewis said she would try and research some of this information to present at the June meeting. Jane stated that she would research the amount of respiratory depressions related to alcohol withdrawal and report back to the PNCC. 3) The new Charter for the PNCC was adopted with one final addition of an RN to do orientations of new RN’s to St Charles. Tiffany Fredericks brought the committee up to date on which UPC has used the roll over fund to date. The only one is the ICU. There was some confusion as to whether this fund would cover food at the lecture. It was decided that it would as the PNCC educational fund does cover meals with lecture/conference attendance. She will report in June what the total is for the roll over fund usage. 4) John Nangle will head up a survey for RN’s related to staffing. The purpose will be to gain information to the effects (if any) changes in staffing have made on their professional practice. The survey will be short, approximately 5 questions and will try to be unit specific. The survey will be available on the units in hard copy and there will be an email component. Meeting adjourned 1000, Respectfully submitted, Vikki Hickmann RN PNCC Chair |
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| 4/21/2008 |
PNCC MEETING MINUTES 4-14-2008 |
| Professional Nursing Care Committee Meeting Minutes April 14, 2008 0900-1000 Present: Vikki Hickmann, Linda Coates, Sue Davidson, John Nangle, Joe Sack, Tiffany Fredericks, Terri Lewis This hour long meeting was an orientation session lead by Sue Davidson RN PhD from ONA in Clinical Practice. The new PNCC notebooks created by ONA were handed out to all members present. There was a special meeting of the Staffing Committee from 0800-0900, called by Jane Hansen CNO, Cascade Healthcare Comm. The PNCC Chair, UPC reps and Sue Davidson were invited to attend. The subject of this meeting will be discussed at the May PNCC meeting or members may discuss the subject matter with those who attended the meeting. Respectfully submitted, Vikki Hickmann RN PNCC Chair |
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| 3/15/2008 |
PNCC MEETING MINUTES 3-10-08 |
| Professional Nursing Care Committee Meeting Minutes 3-10-08 0730-1000 Present: Terri Lewis (CCU RN). Kathy Phillips (Med RN). Karen Stanard (ER RN), Vikki Hickmann (ER RN) 1) Staffing committee report unavailable. Terri Lewis reported on the unit rep meeting last month. She states that the reps now know about the new SRDF paperwork and that she will be working with John nangle on making sure that new forms are in the unit notebooks. Vikki Hickmann reported on the process of notifying and orienting the UPC chairs as to the utilization of the rollover fund usage. UPC chairs from ICU, IMCU, ER, Behavioral Health and Ortho/Neuro were given a packet of information and explanation of the process given in person to each one. Now, the committee waits to see how the units will act and the committee is available to help as needed in this new process. 2) Karen Stanard reported on the fund management process. She has had some requests from RN’s for items that do not specifically relate to education such as wanting reimbursement for RN licensure. Karen and/or Tiffany will bring any questionable requests to the committee for input. The fund is set up for education of RN’s related to their practice and in some cases self improvement as will be beneficial to the RN’s practice (such as classes like heart math etc). The committee will have input in cases that may be ambiguous. We want the RN’s to know there is an email on web outlook that is specifically to the PNCC. Just need to put in “pncc” as the address. Karen brought up the idea to keep track of quarterly expenditures to track more closely where the fund total is. Karen also will be working with the education dept. to possibly have a web site in house available to inform RN’s of statewide educational offerings further into the future so that nurses may better plan their expenditures. The example is if a nurse needs trauma education and the class they want is not offered until December the fund may be depleted to the point that they are unable to use the current year funds. If they knew about the class earlier, they may be able to apply for funds sooner. The PNCC is still waiting for any RN’s with an interest to participate on the committee to contact any of the members or Duke the bargaining unit president or Alison Hamway the ONA rep. We are planning an orientation of new members and for those members that never received official orientation at the April meeting on the 14th at 0730 Center for Health and Learning class room H. Meeting adjourned 1000 Respectfully submitted, Vikki Hickmann PNCC Chair |
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| 2/15/2008 |
PNCC MEETING MINUTES JANUARY 2008 |
| Minutes for Professional Nursing Care Committee Meeting Thursday January 10,2008 100-1230 Members present: Karen Stanard (ED), Tiffany Fredericks (FBC), Terri Lewis (CCU), Vikki Hickmann (ED) Agenda item one information presented by report. Linda Coats RN chair of hospital Staffing Comm. Gave an update on general activity of the committee. There are some deficits in committee representation, specifically RN part from FBC. This will try to be rectified by Tiffany Fredericks bringing this to the attention of former FBC staffing comm. Member. They will then organize an election / consensus vote to pick another RN from their unit. An up to date report of staffing incident reports (SIR) and staffing documentation request forms (SDRF) will be given to Linda by Terri Lewis (staffing report manager) for presentation at the Feb 12th staffing comm. meeting. Terri is compiling data from the two (2) forms on a spreadsheet and categorizing certain criteria obtained from the reports. It seems there continues to be some uncertainty by RN’s as to how to fill out staffing forms, where to find them and who to send them to when they are completed. Terri will be contacting John Nagel to give a presentation at the next Unit Rep. meeting to hopefully answer some of these questions. Education fund managers report (Tiffany Fredericks and Karen Stanard) informed the PNCC that all the funds were used for 2007. It was reported that Keryn Glass is doing a great job and that her addition has really helped the distribution of educational funds. Thanks Keryn. Item two discussed the use of the 2004-07-contract roll over funds (pg 71 of recent contract). The committee decided to use the UPC as the unit based decision-making body for direction of the funds. There will be criteria for fund usage with the distribution of the funds in keeping with the contract. The distribution will utilize the present system, meaning the PNCC fund request application form and there will be an additional spreadsheet created specifically for these 3 annual distributions in the amount of $ 14, 857.33 per year. Oversight for the use of the funds will be achieved with the reporting of expenditures and an evaluation by the UPC chair of the educational process. The UPC chairs will be invited to the Feb 12th PNCC mtg at 1300. Vikki will have specific criteria written up to be presented to the chairs at that meeting. Item three was discussed and the committee decided they did not want to plan a staffing education class at this time. The committee decided it wanted to wait to have that class in conjunction with orientation of new PNCC members after the election. Email has been sent to Duke Sells regarding organization of an election. Discussion regarding sponsoring nursing students for convention was thought to be more appropriate at the District level as the PNCC education contract funds are not appropriated for that purpose. Item four discussed the use of the new PNCC email address. Karen Stanard will be sending out an email from this address to all RN’s explaining its purpose and function. We hope to increase communication between all RN’s and allow them a way to get specific questions answered in a timely manner. Meeting adjourned 1230 Respectfully submitted, Vikki Hickmann PNCC Chair |
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| 2/15/2008 |
PNCC MEETING MINUTES FEBRUARY 2008 |
| Professional Nursing Care Committee Meeting Minutes 2-12-08 1300-1530 Present: Terri Lewis (RN CCU), Michi Sato (RN ED), Linda Coats (RN ORTHO/NEURO Chair Staffing Comm), Anne Coleman (RN Operative Services), Vikki Hickmann (RN ED, Chair PNCC), Kathy Phillips (RN MED), Alison Hamway (ONA). Leslie Toll (HR), Keryn Glass, (PNCC Admin Assit.) Karen Fitzgerald (Education), Joe Sack,(RN IMCU) Liz Lefever (RN IMCU) 1) Report regarding Staffing Comm. from Linda. They have gone to quarterly meeting and will change as needed. All minutes and info regarding the Staffing Comm is on the “I drive” and may be accessed by Nursing. Linda reported that the comm. is observing the new ability to monitor patients from IMCU on telemetry units and how this will impact need for additional staff. She is on the committee and Kathy Phillips is on the UPC on Medical floor where the new program will start. All committees will be watching to evaluate the effects on patient care and RN workload. There will be an evaluative process after the system is in place therefore any input to the committee over seeing this implementation will be needed. Report from Terri Lewis regarding the accounting of filed Staffing Incident Reports (SIR-Hospital) and Staffing Request Documentation Forms (SRDF- ONA) given. She found that there are primarily SIR forms filled out and very few SRDF. We do not know if we are not receiving them or if they are not being filled out. Terri plans on going to the next Unit Rep meeting (Feb 25th, 0730 classroom C) to speak to this issue. Remember that the SRDF is kept in the ONA notebooks, which should be on all units. If you cannot locate them please contact the Unit Rep on your unit or contact a PNCC member and we will get one to you. You may email Terri Lewis or email the PNCC from the hospital email system. 2) Discussion with ONA and HR regarding using the roll over funds that were agreed upon in the most recent contract page 71. The PNCC wanted these funds to be made available for Unit Practice Committees to apply for. The funds would be available to 1/3 of the UPC’s each year for the next 3 years. (the fund is being dispersed by making available $14, 857.33 per year for 3 years). The total amount $44, 572 works out for 655 RN’s to be $68 / RN. Therefore the PNCC wants to allow a UPC to apply for this fund, in the same manner an individual RN applies for PNCC funds. The discussion was required between the Hospital and ONA (as this is a contractual issue) to clear up any confusion and allow the PNCC to move forward with the process. Agreement was reached and now the PNCC will move forward to talk with the UPC chairs and clarify the process of fund application. Vikki Hickmann will try to get on the agenda of the next UPC chair meeting so that she may present this information. We hope this approach may help each unit participate in education that specifically meets the needs of their units. We hope it will foster an environment of collective contribution. There was also mention made that one PNCC member was asked for “ a PNCC voucher” when she put her time for PNCC business on the supplemental time sheet. Leslie Toll said this should not happen. Leslie Toll also said she would provide the PNCC with the totals of PNCC hours used per month for the months of Oct. Nov. Dec 2007 and Jan.2008. 3) Vikki will write up an example of the process for this special fund application, including a process for evaluation. This will be given to the PNCC for comment and then presented at the UPC Chair meeting. 4) Joe Sack and Liz Lefever came to the PNCC to discuss resources and strategies to improve their unit (IMCU) and help the UPC be more effective. The PNCC gave suggestions as to process and referred them to the contract that explains what the PNCC function is. Linda Coats gave information of evaluation of staffing standards and acuity, in general. Joe and Liz spoke to there wish to improve their patient care and staff participation in self-governance in IMCU. They also spoke to the support they get from their management team to help them accomplish these goals. The PNCC would like to thank Liz and Joe for coming and allowing us the opportunity to help them. That is what we are here for. 5) Meeting times for the remainder of 2008 were decided upon and rooms will be scheduled in the next week. This will go out to the stcharlesnursing.org web site and be posted on the lower level ONA bulletin board. Meeting adjourned 1530 Respectfully submitted, Vikki Hickmann RN, PNCC Chair |
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| 12/13/2007 |
PNCC MEETING MINUTES 12-11-2007 |
| Minutes for Professional Nursing Care Committee Meeting Tuesday December 11, 2007 1130-1330 Members present: Karen Stanard (ED), Tiffany Fredericks (FBC), Vikki Hickmann (ED), Alison Hamway (ONA ) Agenda item one was discussion surrounding the 2008 PNCC election. The committee may have up to 12 members. At present we have six. The negotiating team, specifically Duke Sells and Alison Hamway will be coordinating the election in January. It is important that with approximately 655 RN’s we have representation from as many units as possible on the PNCC. Item two discussed the upcoming CNO interviews and PNCC involvement in the process. Dates will be finalized and locations given to the PNCC from Duke Sells communication with administration. Item three discussed the process of the restructuring of the Family Birthing center and concerns were brought to the attention of the PNCC by an RN from that unit. Alison Hamway also stated there has been some discussion around changing how triage is presently done in the dept. and also some changes surrounding Lactation consultant utilization. As some may know the FBC has increased the bed size with their remodel and staffing issues have been of concern to the practicing RN’s on that unit. The PNCC recommended that the FBC staffing committee rep. research present and recommended staffing model, as suggested by management, and compare how this relates to the Standards and Guidelines for Professional Nursing Practice in the Care of Women and Newborns as put forth by Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN). As part of the Staffing Law, under 333-510-0045- Nursing Services Staffing 3e, it states, “ the written staffing plan must: be consistent with nationally recognized evidence-based standards and guidelines established by professional nursing specialty organizations, such as, but not limited to, The American Assoc. of Critical Care Nurses, American Operating Room Nurses (AORN), or American Society of Peri-Anesthesia Nurses(ASPAN).” Item four discussed how RN’s are filling out the Staffing Incident Reports and Staffing Request Documentation Forms. It seems that nurses are filling out both forms and sending them to the staffing office. There will be a reiteration of the fact that the hospital does not recognize the ONA form (Staffing Request Documentation Form), so there is no reason to send them a copy. The ONA form needs to be sent to the PNCC and the hospital staffing incident report goes to the staffing office. The hospital form is reviewed by a member of the PNCC (Terri Lewis), and the data is tabulated on a spreadsheet. This information will be clarified in a St Charles Nursing website letter from the PNCC chair this week. Item five announced that hopefully in the next 1 to 2 weeks there will be a PNCC email address set up by the hospital IT dept. This will allow nurses to ask about their educational funding, ask for issues to be put on the PNCC agenda or anything else one may want communicated relating to PNCC functions. Item six informed the committee that changes in the PNCC education disbursement work instruction is still in progress, and we will keep the members informed when any changes are finalized. Meeting adjourned 1330 Respectfully submitted, Vikki Hickmann PNCC Chair |
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| 12/13/2007 |
LETTER TO RN'S FROM PNCC CHAIR |
| Letter to Registered Nurses from the Professional Nursing Care Committee Chair Happy Holiday! I wanted to just write an informational note to clear up a few things. Some of you may already know all this, but some may not. First, it has come to our attention that some may not know where to send the Staffing Incident reports (SIR-Hospital) and the Staffing Request Document Form (SRDF-ONA). The SIR goes to the Staffing Office and the SRDF goes to the PNCC. Inter-dept. mail may be used to send both of these forms. If you forget where to send the SRDF, refer to the notebook (which should be on every unit) and there are instructions. There are also instructions at the bottom of the SRDF and there are instructions about the SIR form in the work instruction and also in the unit notebook. If your unit does not have a notebook, please let your unit rep know this and if you need a notebook made for your unit, please let the PNCC know (by inter-dept mail) and we will make your unit a notebook. I have gone to a few unit rep meetings and have spoken with the unit reps regarding this, but I will speak to them again at a future meeting. There will soon be a specific PNCC email address, so hopefully this will improve communication. Second, we have used enough of the education fund that we will be able to roll over the balance into the next years fund. As you may know, with the new contract we can only roll over 10% of the total budget, any other portion of the fund not used is lost. There are additional monies that were carried over from the last contract. As some may know in the former contracts, the language stated that all educational funds not used would be rolled over to the next year. This was never done. The solution to this, negotiated during the most recent contract negotiations, came up with the solution to roll over the funds not spent from 2004. This totaled $44,572. The decision was made to make 3 annual distributions in the amount of $14,857.33 in addition to the annual fund. This information is in the contract on the last page in a side letter of agreement. If anyone has any ideas of how to utilize this fund, please let us know. Please refer to the criteria of “how to bring an issue to the PNCC” on the web site or email me at vikhic@gmail.com, or speak to any member on the committee. There will be an election for the PNCC in January. We may have up to 12 members, as of now we have 6. It is important that we have fair representation from as many units as possible. Please give it some thought; this is a working committee and we need your help. We are trying to stay current on changes that are happening with some unit restructurings. We have relied on updates from the nurses in those specific units to help us be aware of any concerns related to the practice of nursing, including utilization and staffing of registered nurses. We also would like to remind everyone that their Staffing Committee Rep is a great person to speak to about concerns with the over-all staffing model and if the staffing law is being followed. We are all inter-related and each group supports each other in promoting quality patient care and improving the practice of nursing. Get involved and make a difference in your professional practice. In closing, I would like to thank every nurse for their hard work and caring determination that helps us create a better place for everyone at St Charles. I know what it is like to be at the bedside and I know the issues involved. I hope you and your loved ones have a great Holiday Season, take care, Vikki Hickmann, PNCC Chair |
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| 11/15/2007 |
PNCC NOVEMBER 13.2007 MEETING MINUTES |
| Members present: Anne Coleman ( OR), Karen Stanard (ER), Vikki Hickmann (ER), Tiffany Fredericks (FBC) The discussion regarding the restructuring of the OR and Surgicenter and all other units related to OR (PACU, pre-surg ) included nursing concerns. These concerns were directly related to the suggestion that all nurses involved were to be trained to broaden their duties, such as being able to scrub in on all types of cases. Nurses from the OR stated that they thought this would generalize their practice versus specializing their practice. The fear of this was that they would not be as skilled in some areas and that they were worried this might decrease the skill level in the OR there by possibly compromising competency and quality care levels for their patients. Other concerns related to the Surgical Services (OR, PACU,Surgi-center etc) were identified by OR nurses and brought before the PNCC. One was the documentation of mandatory overtime as outlined in the Staffing Law specifically OAR 333-510-0045, that states, “ each hospital must have a system to document mandatory overtime. The procedure must be clearly written, provided to all new nursing staff, and be posted in a conspicuous place.” There is a work instruction explaining CHS philosophy on mandatory overtime (W22292), but this was not posted in a conspicuous place and the awareness of nurses regarding the documentation was deficient. The solution was that one of the OR nurses has placed this in a notebook with copies of the form and work instruction so as to make it easier for nurses to fill this out when appropriate and to educate themselves regarding this important policy. A second concern for the OR was the overall effects of the restructuring process, specifically regarding potential contractual conflicts. The PNCC has referred all contractual issues when concerning labor management to the negotiating team. The PNCC encouraged the negotiating team involvement where necessary in the restructuring process. Educational standards by department were compiled and summarized by Karen Stanard. She will be sending this information to Keryn Glass as a reference source used in educational reimbursement process for PNCC. Karen Stanard will also be assisting in the PNCC educational fund disbursement process. There will be an addition added to the work instruction for PNCC contractual education funds (W18003). There will be a statement saying when using the inter-dept mail to request funds from PNCC, to send it to: PNCC Education. Many times people are sending it to other members of the PNCC who are not involved in educational fund disbursement. Sending a request to the wrong address can delay reimbursement of funds. Tiffany Fredericks will be working on getting an email address for the PNCC to increase communication between all RN’s and the PNCC. We are also working on some ideas how to best utilize the $44, 500 carry over fund from the previous contract. We want it to be used equitably by all RN’s. Vikki will be contacting all UPC chairs and Karen will be working on a list of ideas that the funds could be used for. There will be criteria for utilization of the funds should we follow through with the plan. We will keep you posted on the final decision. Respectfully Submitted, Vikki Hickmann RN, PNCC Chair |
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| 11/15/2007 |
LETTER TO BEND RN'S FROM THE PNCC CHAIR |
| To all Registered Nurses at St Charles Medical Center in Bend, I am writing to let you all know how the Professional Nursing Care Committee of Bend is doing. I will try to categorize the data into topics and then will give a brief summary of progress. Education: most everyone knows the PNCC as the disburser of educational funds. It is a big part of what we do in the general promotion of “working constructively for the improvement of patient care and nursing practice.” (Article 14 #2 page 45 of the contract) There have been some changes I think you should know about in the process of how these funds are disbursed. We now have an administrative assistant, Keryn Glass, who is assisting with the processing of the monies allocated for education. Tiffany Fredericks (FBC) and more recently, Karen Stanard (ER) are the RN’s who oversee the specific allocation of these monies. The committee also has input on educational allocations that may be more complex and require further consideration. Now that we have approximately 655 RN’s this process is big and can be quite time consuming. To help facilitate this process, when submitting your request please send it in the inter-dept mail to: PNCC EDUCATION. This will get it to the right people and hopefully expedite the fund allocation process. Staffing Incident Reports/ Staffing Request Documentation Forms: Terri Lewis (CCU) is the tabulator of this information. She is trying to set up a spreadsheet and organize all this information. Terri brings monthly reports to the PNCC and if there are specific concerns in areas of patient care we address these as soon as possible. We always want to know about concerns with practice of nursing and patient care and will always try to help find solutions for nursing when possible. Anyone is invited to any of the PNCC meetings. Please contact me, Vikki Hickmann chair, by inter-dept mail (ED), or by email at scmc.org if you would like a specific item on the agenda or just show up to the meetings. We will be setting dates for the 2008 meetings at the December meeting and these will be posted on the stcharlesnursing.org website calendar. Membership: The contract reads the committee shall be “composed of not less than eight RN’s and not more than 12 RN’s employed by the hospital and covered by this agreement.’ (pg 45, Article 14.1) We presently have six members: one from medical, one from CCU, two from ED, one from OR and one from FBC. We are able to have at most six more members and need at least two more. I have spoken with Duke Sells the ONA president of our hospital about the need for an election. This committee is dynamic, committed to promoting quality patient care and the improvement of nursing practice. I believe we are creative and are hard working. It is a forum that has the ear of the administration and lends an opportunity for professional growth. I would encourage any who have ideas they would like to have presented and implemented, this is an avenue where that can happen. Please contact any of the members if you have questions regarding the PNCC. Please read about the PNCC in the contract. In brief summary for the year 2007, the PNCC has had influence in some areas. The education fund process was taken over by 2 RN’s and has continued to meet the needs of the RN”s (even though the numbers of RN’s increased significantly). We did use all the education funds for 2006 (the first time this has happened). The PNCC made presentations during contract negotiations, resulting in an increase of educational funds. The process of tabulating staffing request forms has improved. The PNCC helped organize the election of the Staffing Committee. The PNCC continues to support this process by ongoing communication with the RN chair of the Staffing Committee. The PNCC provided a forum for the discussion and re-creating the process of inter-shift and inter-dept reporting by facilitating change (along with many others) from Optivox to verbal reporting. That is a small amount of information about the PNCC. I would like you all to know how important this committee is to the future of nursing. We have the potential to influence the future of health care. The PNCC can be the vehicle for this, Sincerely, Vikki Hickmann RN, BSN,CEN, PNCC Chair |
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| 6/14/2007 |
P.N.C.C.MEETING MINUTES 6/14/07 |
| P.N.C.C. Meeting June 14,2007 Present: Vikki Hickmann, Terri Lewis, Angie Streeter, Karen Stanard, Anne Coleman, Tiffany Fredericks, Cheryl O’Donnell. Agenda item #1: Open Forum. Report from Linda Coats regarding staffing committee. Linda Coats was not able to attend. Anne Coleman asked for discussion about “mandatory OT”. She explained that there is confusion about the mandatory OT rules, as they apply in O.R. We do not have the written explanation for mandatory OT here today, so discussion was only anecdotal. Linda Coats may be able to clarify this issue. I will also get the official guidelines from ONA and post them on the P.N.C.C. minutes posting site in the near future. Anne also suggested that we develop a method or form, the units could use to track the mandatory OT activity. Vikki suggested we review the P.N.C.C. goals. Now that we are mid-way through 2007 we can assess our progress toward the goals we set for this committee, last fall. This will allow us to measure our progress, and make changes if needed. We should each think about the role of the P.N.C.C. Vikki suggested that one of the role of this committee is to be the liaison between individual nursing issues and the S.C.M.C. administration. This discussion was stopped when our guest, Allison Hamway arrived. Agenda item #2: John Nangle, brought written comments and concerns form nurses throughout SCMC – Bend about the Optivox system. We will read these, and ask for unit RN input via the UPC’s. The system takes between 3-6 min / pt, to record report. That 12 – 24 min for a 4 pt assignment. Then RN’s meet face to face for final pt. reports and questions. In specialty units, pt conditions can change rapidly, making the recorded info obsolete by the time the RN’s meet face to face. This equals wasted time. We ask John to return again next month for further discussion. We were also interested in how much this system cost for software and training / what was the extent of nursing imput in selecting this system. Agenda item # 3: Alison Hamway, ONA rep. for S.C.M.C. – Bend R.N.’s., gave a review of contract issues concerning the P.N.C.C., and the latest in negotiations with the administration. The 3 contract issues R/T PNCC are : - the hosp. would like to offer the an administrative assistant to help with the management of the Education funds, ie receiving request forms, keeping track of each RN’s allotment of funds, keep records of funds, type minutes, etc. - request for increase of PNCC funds, and reimbursement of funds not carried over in past. - Increase # of payed hours for PNCC members. Please access the negotiating team postings for the details. We had discussion on each point. We were also honored to have an impromptu discussion with Lesley Toll, SCMC HR Manager. She was very kind to give us her explanation of some of these issues. Next months agenda ideas : -More discussion of the Optivox system from John Nangle. We will also be checking in with the UPC ‘s to get the nurses point of view. Also, checking to see how many RN’s were asked to give imput prior to purchase of the system. -SRDF - Allison Hamway will talk with to Carol Valasquez about staffing report forms (SRDF / RSIR). -Lynda Coats to explain more details about mandatory OT. Respectfully submitted, Karen Stanard, R.N. FYI : Director of Education = Karen Fitzgerald. Staffing Comm. Administrative lead = Karen Ellis |
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| 5/8/2007 |
P.N.C.C. MEETING MINUTES MAY 8, 2007 |
| PNCC Meeting Minutes: May 8, 2007 Attendance: Vikki Hickman, Kathy Phillips, Cheryl O’Donnell, Angie Streeter, Terri Lewis 1st 30 minutes: Open Forum: Linda Coats cancelled staffing meetings due to Opitvox meeting. Vikki Hickman asked for update of previous meeting (April 19, 2007). Angie Streeter spoke of issues from previous meeting of “not staying on track.” Terri Lewis will work with Keryn Glass to formulate a spreadsheet for SRDF form. Next Unit Rep meeting will be 5/21/07: Objective is to keep ONA books up-to-date. SRDF discussion: Vikki and Kathy set ground rules on meeting (the role in meetings) in creating or managing SIR (hospital version) and SRDF (ONA version) forms. We (PNCC) are “consultive” (can give our opinion) but have no decision making ability. Karen Stanard has complete information on this matter in the 4/26/07 minutes. Carol Velasquez and Karen Ellis have the “final decision.” The next scheduled meeting with Carol is 5/17/07; this is to continue work of SIR form. Our work today: How do we want to present “the nurses” concerns to the above mentioned meeting? Vikki is firm on using two separate forms, as they serve two separate purposes— Staffing issues vs Nursing issues. This stance is understood by Kathy and Angie since the SIR form is an internal hospital document meant to help the hospital understand where and how staffing insufficiencies occurred and CHS refuses to allow copies to be retained by the reporting nurse nor have a copy sent to ONA. Carol V. has stated many times that this is to make sure the document remains undiscoverable in a lawsuit. In Kathy, Angie and Vikki's opinion that leaves a nurse exposed and helps to cover the hospital even if though there were staffing problems that were reported. Therefore, for the time being at least, it is wise for each nurse to continue to fill out both the SIR form (it is our responsibility per terms of our employment) and the SRDF form to cover RNs legally and to allow the ONA to track dangerous trends affecting patient and staff safety. Forms need to be “quick, efficient, and easy to fill out” or they won’t be used, according to Vikki. Vikki feels the SRDF form accomplishes this, as it has a simple check box format, but for now both forms must be filled out. Kathy offered to speak with Karen Ellis to get insight into why the folks in the staffing office and the bedside nurses use the same form (the SIR form). The agenda for the next meeting with Carol: (Vikki will address these issues with Carol) 1) Will ask for Risk Management to attend subsequent sub-committee meetings on SIR form 2) Continued use of two forms 3) Nursing friendly; and the nurse deserves to retain a copy of SIR form. If SIR form issue is not resolved with Carol, the issue can either go through negotiations or to Labor Management committee. PNCC Update: Changes will be presented for negotiations and will be presented at next negotiation meeting on 5/16/07. Fund amount to be increased for educational budget. Increase number of committee members. Debbie Rief and Vikki Hickman will make the presentation to the negotiating team on 5/16/07. Respectfully submitted, Cheryl O’Donnell (substitute secretary), May 18, 2007 These minutes updated and corrected May 25, 2007. |
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| 4/26/2007 |
PNCC - SCMC MTG. |
| P.N.C.C. and S.C.M.C. Meeting Purpose: To discuss the format and Utilization of the Staffing Request Documentation Form. Date: April 26,2007 Time : 10 am Present: Vikki Hickmann, Terri Lewis, Kathy Phillips, Karen Stanard, Carol Velasquez, and Karen Ellis • Agenda item #1: What process will we use to reach agreement? Each person gave her ideas. Vikki - she feels we should work as a partnership, using collaboration to reach a decision. Each person can put in ideas to reach a common goal. Carol- she feels this is truly an internal hospital process. She works from a process model of “Resposibility, Accountability, and Authority”. There are also certain internal requirements that have to be met. The “Risk Management” committee has to review and approve any decisions. They have input, as to what can and cannot. be in a process. Carol would like to work together, but stated that she views the PNCC involvement with the SIR forms as consultative only, and that the final decision will be made by Nancy Moore and Carol. Their decision will then be reviewed by “Risk Management” and “Quality Management” She mentioned 2 other types of agreement: collaborative and consensus. She stated that the Staffing Committee works in the Consensus format. This allows each member to express their own opinion. These opinions are reviewed by the group, which then comes to a consensus. Everyone then honors this decision(even if they don’t agree totally). Carol also feels that the SIR forms come under the scope of the Staffing Committee. The process of the Staffing Committee is defined as: Develop, Monitor, and Revise. She feels the SIR form falls into the monitoring part of the Staffing Comm. Kathy- she would like to have goals written out. She would also like to clarify what the “risk management” limitations are. This would help us be more efficient in forming a workable process. • Agenda item #2: What is our common purpose? Terri- to improve the delivery of safe, quality patient care. These forms allow us to see trends, which ultimately helps us to improve our pt.care. Kathy- to make it easier for staff to fill out an incident report. Make the actual form cleaner. Make the process more efficient. Carol- she agree’s with Kathy’s concerns, but would like to add ; the ability to gather and retrieve data. It should acknowledge the data that will not be seen in the trends (ie: problems in staffing that were resolved before they became problems for pt care. These would include a short staff situation that was fixed before the shift started). Some of that data can be obtained via “One Staff”, but not all. Karen Ellis- she feels it’s all about process improvement. We need fewer errors in getting info from “One Staff”. She is working on ways to pull out problem trends. One the problems is that a person has to look at each form and enter the data it presents. This is time consuming. Currently the flow of a SIR form goes from the “reporter” to the AUM, to Karen Ellis, then to the Unit manager. The unit manager then interviews the staff member(s) involved. There was concerned expressed about the possible problem of having the Unit Manager interviewing the reporting Staff member. The staff member could feel threatened or intimidated into “under-reporting” because of fear of retribution. Or, the Unit Manager could “under report” the final evaluation of the report. Karen E. said the her usual handling of a SIR form is to investigate the incident by interviewing the repoting party, the Staffing office, and the Unit manager. She then looks at all this info and determines what seems to be logical. She then makes it a point to respond and explain her final evaluation of the incident to each party. Carol said she looks at trends, not just what the manger says. Terri asked Karen if info is captured from “one Staff” or the SIR forms. Karen said, only the SIR forms. Vikki- she feels the purpose of the SIR form should be to report what is happening for “a pt./RN that day” The PNCC’s view is concerned about how each RN can deliver care in a safe and legal manner. She would like the PNCC role in perfecting the SIR form to be more equal with SCMC. She would like to have the nurses experience to be looked at equally with that of the SCMC legal needs. She also feels there has been some mis-communication on the issue of SIR forms in the past. She would like us all to work together to avoid more of the same. • Agenda item #3: What are our interests in this issue? Vikki- her interest is creating “Ease of documenting”. This includes the variances of the day in patient care. Also to document missed breaks or lunches. Carol- showed us the SIR – Draft revision. We looked over some of the additions to the form and it’s layout. PNCC members would like time to look at these changes, and discuss them later. All parties present discussed a “Communication agreement” amongst ourselves. We agreeded to contact to contact one another with any concerns or changes in the SIR form(so we all stay on the same page). We will reply to these emails or phone calls within 3 days. Thank you to everyone for make this commitment. Carol V- Ph# - 322-2780…… cvelasquez@scmc.org Karen E. – 322-2750…………kellies@scmc.org. Karen said to call her back if she doesn’t get back to you. Next Meeting : May 17. 8:00 AM. Location to be announced. Agenda: 1) What do we want out of the SIR report(what data do we want to capture and why)? 2) Email each other if we think of other agenda items. Meeting adjourned. Respectfully submitted, Karen Stanard |
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| 3/13/2007 |
P.N.C.C. MEETING MINUTES 3-13-2007 |
| P.N.C.C. Meeting Minutes 3-13-2007 : Time : 0800 - 1030 Present : Angie Streeter, Terri Lewis, Kathy Phillips, Jessica Oddo, Tiffany Fredericks, Anne Coleman, Karen Stanard. Cheryl O’Donnell. Agenda item # 1 - Reports from PNCC members: Jessie Oddo – Vice Chairwoman- Reported on the Clinical Practice Committee Meeting (previously named Leadership Council). This committee currently has a total of 54 members. This large of a group makes it cumbersome to get work done. Several of the topics they are working on are; 1) Adjusting the workload of the Clinical Supervisor to reduce the amount of time spent in meetings and instead free them up to be working in their units, 2) Implementing / training for the PIXIS system, 3) troubleshooting the pneumococcal vaccine administration process, so appropriate pt.’s receive the vaccine prior to discharge, 4) documentation via EMR. Moving the DAR notes onto the form browser. This will make them a more usable part of the charting process, and better for pt. care. Terri Lewis – Reported on the progress of the SRDF forms. We discussed the possibility having R.N.’s fill out only the ONA form and submitting it to the hosp for all problems. This may push the issue a bit, but also test the ONA form to see how it works for SCMC. One member said that the SCMC has been returning any ONA –SRDF forms they get, back to the RN submitting it. We are hoping that the meeting planned with Carol Velasquez in May ( postponed by Carol from March to May) will bring us together. Our goal is to have SCMC and the RN’s using the SRDF forms as a tool to improve pt care and safety at SCMC. Agenda item # 2 – Proposed contract changes to improve the P.N.C.C. and the Education fund. We read the contract relating to the PNCC and would recommend some changes to the contract regarding: Article 14.1 – We would recommend changing the wording to “…composed of not less that 8 , not more that 12 R.N.’s…”; “ …holdover members, and “not more than 2 members from a single clinical area.” We would eliminate the other requirements relating to shifts and part-time status. Article 14.6 - We would change the meeting time to 2.5 hours/month/member. “Additional hours” need to be changed to reflect the time spent doing the work of the P.N.C.C. outside of meeting times. The hours requested are: Managing / dispersing P.N.C.C. Education funds = 24 hours/month Secretary = 2 hours/month Chairman duties = 4 hours/month The above three categories would be monthly requirements. Total = 30 hours/month. Sub-committee work - up to 10 hours / month to be used by any P.N.C.C. member doing extra work for the P.N.C.C. committee. Total payed hours requested includes; meeting time (2.5 hr x # of members, 8-12) =20-30 hr Required monthly jobs (PNCC Ed. Fund, secretary, Chairman) = 30 hrs Sub –committee work- =0-10 hr Article 14.10- PNCC Ed Fund managers must have a permanent designated work space and use of permanent or laptop computer, and file cabinet. This space must allow for a table large enough for 2 persons utilize. Currently there is no permanent space, and they have to locate an area with a computer each time they need to work. Article 13.4.1 Funding - (of PNCC Education Fund)- The current dollar amount is $110,000.00 . This amount was set when SCMC had only 450 RN’s. We currently have 650 RN’s. We are recommending an increase to no less than $325,000/yr. This takes into account the increased RN’s and the increase in tuition/travel expenses/ salary reimbersement. (650 x $500.00 = $ 325,000). Agenda item #3 - Anne Coleman said that the ONA book on their unit(O.R. or F.B.C) was out of the ONA SRDF forms. She did not know where extras were kept. Terri said she would contact John Nagel. He was coordinating the UPC reps to restock the books. She will also contact Sue Davidson to get more forms sent to us for replenishing the unit notebooks. Discussion was had about R.N.’s not getting their breaks and lunches. Oregon labor law states that you shall receive a 15 min. break for every 4 hours worked. Shelly Leander-Lewis says that R.N.’s at SCMC are breaking the law if they are not taking their breaks. The attitude on some units does not encourage taking breaks (ie- we have never taken breaks here, so if you want a break you are looked down on as not being a team player; or you are asked to break each other. This is many time impossible due to the acuity of your pt.s) We read the contract, Article 7.7(pg. # 8) which reads “One 15 min. rest period shall be allowed for each 4 hour period of employment. We would like to have the word “shall” defined. Shelly and the negotiating committee has been working on this and the meal break issue. The attorneys from SCMC and ONA have agreed on a LOA (Letter of Agreement)that addresses this. There will be a vote on this subject. Angie also said that our contract supercedes the Oregon Labor Law. There is a survey on the website about breaks. Please engourage all RN’s to complete this. We discussed the use of our ONA rep, Allison, to come to unit meetings to address these issues. This may divert any attitudes from being focused on the RN advocating for breaks. Kathy Phillips returned from the Staffing Comm. Meeting and showed us the “new SRDF form” that Caro Velasquez brought to them. Kathy is confused about this since we were under the impression that Carol, Vikki, Terri, were going to be working together to create a better working form. Meeting adjourned at 1030. Respectfully submitted by Karen Stanard |
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| 1/9/2007 |
P.N.C.C. MINUTES 1 - 9 - 2007 |
| P.N.C.C. MINUTES 1 / 9 / 2007 Present : Vikki Hickmann, Karen Stanard, Anne Coleman, Kathy Phillips Guest : Lynda Coats Meeting was called to order at 0905. Lynda is here to give this comm. an update on the Staffing Committee’s progress. She is happy to report that all members of the Staffing comm.held a special meeting just prior to the holidays in order to reach a concesus on a staffing plan.The new staffing plan is described in detail in a new work instruction, # W09075. This plan takes into account the numbers that effect core staffing numbers in each unit and at each level of caregiver. One big plus, is that the emphasis of the plan is the “patient’s needs”. This took a huge effort from the entire committee and each of the R.N.’s at St Charles should give them a big THANK YOU! We are very proud of you for working together to through this new and trying process. The next step will be implementation of the “ONE STAFF” acuity system at the unit level. Each RN will be trained to enter the acuity for each of their patients. There will also be a review process called “Inter-rater Reliability” implemented to assure the proper standards are used for acuitizing each pt. Thank you, Lynda. SRDF’s Vikki was hoping to get some information that would have allowed us to survey some of the hospitals in the state of Oregon about their SRDF forms. We were unable to get it so we will work on that project for next month. Terri, Karen, and Anne will develop some survey questions so we each ask the same questions. We will then call approximately 4 hospitals each, then review the results and report back to the PNCC. Kathy Phillips and Terri Lewis have been reviewing the SRDF’s that SCMC RN’s have turned to SCMC and to ONA. Kathy reported on the forms she reviewed ( the ones sent to ONA). She tallied all the forms for 2006, between March 6 th and Oct 6 th. . She has placed the data on an Excel spreadsheet. She noted that one area she liked on the SCMC form was where you add the name of the person(s) contacted to report the incident and the time. We noted that the example SRDF from Sacred Heart host. in Eugene has a form with this on it. The committee would like a break down of the type of incidents / unit . The committee need to gather this data quickly so we can use it to for one SRDF to combine both the SCMC and the ONA forms into one. Treasure’s Report : Debbie did not attend , but Vikki reported that all the PNCC Educational funds were exhausted this year, and left 4 RN’ without reimbursement. Vikki did some research and found that the Educational funds were started via the contract negotiations ant the amount of $85k in 1994. In 1998, it was increased to $110k , when there were only 400 RN’s at SCMC. Now, the amount remains the same ( $110 k), but the number of RN’s has increased to 650. There are also more RN’s with seniority that can request p to $ 600 each. We will get some hard numbers and review it further. Meeting adjourned at 0945 Respectfully submitted, Karen Stanard |
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| 12/12/2006 |
P.N.C.C. MINUTES 12-12-2006 |
| P.N.C.C. MINUTES 12/12/2006 Present : Vikki Hickmann, Debbie Reif, Terri Lewis, Jessie Oddo, Angie Streeter, Ann Coleman, Tiffany Fredricks, Karen Stanard Guest : Robin Kemmer. Robin addressed the P.N.C.C. comm. requesting to use her available education funds for a volunteer medical trip to Ecuador. She has already submitted the request to Karen Fitzgerald in order to get administrative approval to grant some of these hours used to fulfill her continuing ed. requirements. The committee asked several questions of Robin, then asked her to allow the comm. some private discussion. We re-read the contract , and ended the discussion by stating we felt that this idea wuld fall into the requirements set out in the contract. We approved the use of Robins P.N.C.C. funds for this purpose. In the future, we fell it will be imperative for an R.N. to obtain the approval of the administration for continuing ed before the P.N.C.C. would grant use of funds . Debbie Reif will change the work inst. to reflect the above discussion. Report from members : S.R.D.F. reviewers - Terri and Kathy Phillips - Terri and Kathy met to review all the collected SRD forms. After review, they concluded these forms collect data for 2 different staffing problems: 1)staffing ( RN’s /pt as it relates to pt. safety and care) , and 2) staffing occurences (ie - noting when a float R.N. is placed into an assignment or a sick call that is not filled). The “One Staff” program currently can track and document the problems discribed in #2 ex: which allows it to track logistical staffing problems. Terri and Kathy stated their goal is to review the SRD forms monthly so we may note trends that need to be addressed by the PNCC and/or the Nursing Administration. Terri then circulated 3 examples of acknowledgementsto be sent to every R.N. who fills out an SRDF. We all read through them and decided on one choice. These noteswill inform the reporting RN that the PNCC recieved the SRDF and tell them the status of the reported problem. We thanked Terri and Kathy for their good work. Vikki said she got a list of Oregon Hospitals that are currently using only the ONA’s version of the SRDF. They number 29. Two other hospitals use a form that is very similar to the ONA form. St. Charles Bend and Redmond are 2 of the few remaining hospitals, in Oregon, that don’t use the ONA form. We want to check on the total number of hospitals are in Oregon and if there are any hospitals represented by ONA that still use 2 forms ( besides SCMC). We don’t know why SCMC doesn’t want to use one form. We will survey some of the hospitals on the list see if they had conflicts with their administrations prior to going to one form. Terri, Karen, and Ann will do the survey and report at the Jan. 2007 meeting. Angie stated that the objective to enter a “staffing incident” (not a pt.) into EMR. Since this report is about a staffing issue and not a pt. issue that no HIPAA violations will occurr. Therefore there is no reason these completed should not be available to the reporting RN, ONA. Co- Chairman - Jessie Oddo- She will be attending the Pt. Care Leadership Council meetings. She will talk to Lynn Wolfer about the schedule. Treasurer- Debbie and Tiffany - Since this is such a busy time for Debbie with the flood of incoming reimbursement forms, they have not met. They are meeting next week to talk about the transition of the treasurer’s job from Debbie to Tiffany and Cheryl. Debbie said that the PNCC ed fund has payed out $99,000.00 for individual RN education and another $7.600.00 to sponsor various ed. classes. The total payed out for 2006 is $106,954.73. There is still a large stack of reimbursement form waiting for Debbie. Thank you Debbie for your hard work in this busy time. New Business - Compare SRD Forms - Vikki gave us 3 SRDF’s to review and make comments. We looked at the SCMC, ONA and the SRDF from Good Samaritan Med. Center in Eugene. Terri recommended, on ONA form, where it reads ...conditions (check all that apply)- to poss. add a check box for admissions to this category. For the SCMC form, where it reads ...”unit stats”- staffing- actual/ target. Do we want to include this? We will continue to work to consolidate these forms into a more useful, and user-friendly tool for everyone involved. Meeting adjorned at 11:00 am. Respectfully submitted, Karen Stanard |
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| 11/9/2006 |
P.N.C.C. MINUTES |
| P.N.C.C. MINUTES 11-09-2006 Present : Vikki Hickmann, Terri Lewis, Angie Streeter, Jessi Oddo, Kathy Phillips, Tiffany Fredricks, Cheryl O’Donnel, Karen Stanard. Guest : Linda Coats The meeting was called to order at 9 am by Vikki Hickmann, chairwoman. WELCOME to the newly elected P.N.C.C. committee members. It is so good to see the number of participants on the committee. Everyone was introduced to each other. Linda Coats gave a staffing committee update: Bruce Humphreys has invited Jim Diegel to attend the next staffing comm. meeting. He would like Jim to see the process the Staffing committee is using and how it is working. Linda said the majority of the comm. prefers the “One Staff” software as a acuity/staffing software. Not everyone on the committee agrees, however. They will continue to work for the best software solution. But, It is clear that nothing will be in place and staff trained by the Jan. 7,2007 deadline (as specified by HB 2800). Therefore, it looks as though SCMC will need to apply for their 1 st 60 day extension (only 2 extensions are permitted before mediation is required) P.N.C.C. members are invited to attend the staffing meetings as a “listen only” guest. Linda is also the nursing liaison for the “Safe Patient Handling” Committee. Linda Enos, ergonomic expert, is working with Ortho / Neuro floor. They have set up a Pilot Program to evaluate the current methods for pt. transfer/lifting via the “slippery sheet and a hover mat(inflates so pt. can be pulled up in bed more easily). The new rooms constructed in the N. Tower will have “ in the ceiling lifts” in each room Thank you , Linda for the update. Vikki reviewed the P.N.C.C. Charter. The new charter has 10 members on the committee. Vikki asked the members to volunteer for a position on the committee. The following are the new assignments for 2007: Chairman - Vikki Hickmann , co-chair - Jessie Oddo Co treasurers - Tiffany Fredricks and Cheryl O’Donnel ( Debbie Rief will train and advise) Secretary - Karen Stanard and Angie Streeter SRDF (staffing incident review ) manager:_____________. Thanks to all members for becoming involved. Better review of SRDF and communication with the R.N. filling out the report is a goal for 2007. We are not to use the EMR “Event Manager” to report Staffing problems, instead use the paper forms. We are recommending that each complaint be recorded on both the SCMC “Staffing Incident Report” and the ONA SRDF form (found in the ONA binder found on each unit). Debbie Reif (treasurer) has estimated that she spends approx 13 hours / month processing PNCC Ed. Funds requests. Cheryl and Tiffany will meet with Debbie to discuss how best to share this job. They will report back to this comm. in Dec. Karen will try to meet with Terri and Debbie to make some suggestion for dispersment of education funds remaining at years end.. Angie Streeter reported that she attended the seminar for both the SCMC negotiating committee and the SCMC-R.N-ONA. negotiating committee. She said it went very smoothly and was encouraged by the mutual “good feelings “ at the end of the seminar. This type of collaborative, instead of adversarial tone is a huge step forward for both parties. Let’s have more of that. 2007 Meeting schedule: January 9, 2007......8 am - 1030 am Feb. 8, 2007..........1400 - 1630pm March 13, 2007......8am - 1030am April 19, 2007........8 am- 1030am May 8, 2007..........8am - 1030 am June 14, 2007.......8 am - 1030 am July 19, 2007........8 am- 1030 am Aug. 16, 2007.....8 am - 1030 am Sept. 11, 2007....8 am - 1030 am Oct. 9, 2007.........8 am - 1030 am Nov. 13, 2007.....8 am - 1030 am Dec. 13 , 2007.....8 am - 1030 am Vikki led a discussion about the SRDF process. The Staffing Incident Report Form is a internal quality document. Nursing is being asked to use the EMR so we can accumulate data and track possible trends. Currently this process is cumbersome at best. We should try to document any issues with short staffing that cause poor pt safety, poor pt. satisfaction, missed lunch/breaks and float utilization. We will try to promptly document and respond to each person filing a report. We shall review the hospital’s form and the ONA for m. Ask yourself these questions while reviewing ; 1)How does it work? Look at the layout of the document(ways & whys), can you tell what was happening. 2) How does the PNCC get feedback - the reporting RN / not just the AUM. We need to think “outside the box” to be able to evaluate / track/respond/ and initiate change if needed. Be prepared to discuss both the SCMC SRDF and the ONA SRDF at the Dec. PNCC meeting. Meeting was adjourned at 1100 am. Respectfully submitted, Karen Stanard |
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| 10/17/2006 |
P.N.C.C. MINUTES |
| P.N.C.C. meeting minutes - 10/17/2006 Present: Vikki Hickmann, Angie Streeter, Debbie Reif, Karen Stanard Guest: John Nagle RN, Linda Coats Meeting called to order @ 0900. Visitor: John is here to speak to the PNCC about a new committee he is starting at SCMC. “Stewardship committee”. This committee would look at hospital-wide methods to make SCMC more enviromentally conscious. John told the hx of the “Green team” at SCMC in the 2003 by Jane Lindgren and John. They began a recycling program for hosp. waste. Interest and budget wained, but has now returned. He has spoken with Jim Deigel about the Stewardship Comm. and was given encouragement to organize the committee. Then approach the board for possible funding. Current enviromental improvements are: 1.) Organic food offerings in the cafeteria. 2.) Oct. 1,2006 - hospital garbage sterilizer. All trash goes there. Vikki gave John some suggestions about setting up a committee, 1.) form a charter to clarify your intentions, 2.) approach the Patient Care Leadership comm., 3.) seek approval of the Board of Directors. Vikki will email Jim Deigel advocating the Stewardship Comm. idea. Congratulation to the new PNCC members: Kathy Phillips, MSVS, Cheryl O’Donnel, Peds, Jessie Oddo, Pt. Care Support, Ann Coleman, Surgicenter, and Tiffany Farfagin, FBC. Angie will put together a new member list. Thanks Angie ! Staffing Comm.: Linda Coats, RN The committee has accepted their charter, Great !!. Their meetings are always Tuesdays. Next meeting is Nov. 14. The comm. reviewed the One Staff software last week and are recommending the purchase of that program.. It worked best for acuity and staffing as well as working with Kronos. It is also less expensive than the other choices. PNCC charter: Changes made to the charter : 10 members on PNCC. Treasure’s Report: Debbie will bring an estimate of the hours she works to manage the PNCC ed. fund requests. Vikki will talk with the administration avout permanent office space. Wendy Scheckter is the new Administrative Liason for Education funds. Debbie reviewed a request from an RN for PNCC funds to help pay expenses for a volunteer experience to Ecudor. The comm. delined this request because this is not purely educational. Goals for 2007: Vikki 1.) To look at the EMR, r/t it’s legallity/ liability/ security. We will ask Sue Davidson for help on this. Open Forum : Oct 26, 2006. 0730 - 1700 classroom E Encourage RN’s to come. They can learn about the neg. comm./ PNCC comm. Advantages and responsiblilites of being an RN at SCMC - Bend. Karen will meet with Debbie and Terri to makea work inst, of the PNCC request form. Meeting adjorned at 100 am. Respectfully submitted, Karen Stanard |
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| 7/29/2006 |
NURSE STAFFING CLASSES |
| ONA's Professional Services Division will be givng Nurse Staffing education in Bend and Redmond October 25th and 26th. The target groups are the PNCC, Staffing Committee ( direct care RN's and Nurse Mgr). I will keep everyone up to date as specifics are formulated. thanks, Vikki Hickmann RN PNCC Chair |
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| 7/7/2006 |
P.N.C.C. MEETING MINUTES JULY 7,2006 |
| P.N.C.C. Meeting July 7, 2006 Attending : Vikki Hickman, Karen Stanard, Terry Lewis, Debbie Reif Guests: Jane Brewer 9 AM Meeting called to order. Jane Brewer Is here to discuss the desire of the administration to work with our R.N.’s toward achieving “Magnet Hospital Status” at St. Charles Med. Center. A “Magnet” designation “recognizes a hospital’s nursing program and demonstrates it’s importance, and the importance of it’s nurses to the success of the entire organization”. The benifits to SCMC would be: improved nursing recruitment and retention, increased confidence with the public, attract a higher quality of Physicians and specialists, reinforces positive collaborative relationships, improves patient quality outcomes. Jane explained how St. Charles would like to plan to work with nursing to acheive the 14 “Forces of Magnitisim” required for application to Magnet Status. The 14 “Forces of Magnitisim” are: 1.) Quality of Nursing leadership 2.) Organizational structure 3.) Management style 4.) Personnel policies and programs 5.) Professional models of care 6.) Quality of care 7.)Quality improvement 8.) Consultation and resources 9.) Autonomy 10.) Community and the Hospital 11.) Nurses as teachers 12.) Image of nursing 13.) Interdisciplinary relations 14.) Professional development See handout or go to web site http://nursecredentialing.org/magnet/contract.html. Jane has requested and received approval from the Executive Comm. for funding to educate a committee that would oversee the process. She suggested that 1-2 PNCC comm. members be part of a group that does some site visits and attends a national education conference on Magnet Hospitals. P.N.C.C. supports the concept of “Magnet Status” with the understandingthat there will be equal representation and equal empowerment, and that discussions will be acted on. Jane will get back to Vikki with a list of needed committee’s for CHC -Bend. Kikki will tak with several R.N.’s at SCMC who have worked at “magnet “ hpspitals. O.N.A. Unit Notebooks : Vikki has updated these notebooks for the P.E.S. unit, E.R., Sageview, and Peds. Thank you Vikki !! WE would like all other units at SCMC to look at one of these updated books and then update their own units book. FYI : Department managers are now reorting to Carol V. or Jane Brewer, instead of Nancy Moore. Discussion about PNCC education funds remaining at the end of the year. These funds are carried over to the next year, but the committee would like to disperse them instead. A sub-committee of Terry, Karen , and Deb Reif will meet to discuss possible solutions to this problem and bring those back to this committee. Meeting adjourned at 11:00 am. respectfully submitted, Karen Stanard |
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| 4/13/2006 |
PNCC MEETING MINUTES |
| PNCC meeting on 4/13/06 Present : Debbie Rief, Angie Streeter, Cynthia Ingman, Vikki Hickmann, Terri Lewis, Karen Stanard ( arrived at 1000 am). PNCC office, as designated by SCMC, currently has 2 file cabinets and a mailbox located downstairs. The desk is gone, so there is no work surface. We will contact Carrie Gatton to aquire more usable space. We will update the situation at next meeting. PNCC EDUCATION - $1000 for speaker for Diabetes assessment class. Upcomming classes that PNCC will be helping to fund include bariatric class and chemotherapy class. The conscious sedation training is mandatory, therefore PNCC felt that SCMC should pay for that training. Pain management class - one hour in the form of grand rounds? Otherwise 6 to 7 hours of pain education offered this fall ( ce units 7.2 = 6 hrs). Pain ed. required by the Stateof Oregon for liscense renewal. OSBN has one hour pain requirement available online. PNCC is backing pain management ed.. It is important to establish ed. for the community and possible future ed. as the need for chronic pain clinics increase. PNCC will need cost requirements for these classes to consider sponsoring these classes. Need to speak to Katie Kimmel for recommendations for cost containment . Need to checl with OSBN for taping of pain classesfor those not able to attend. Funds should be provided for SCMC contract nurses only. PNCC budget is $110,000.00 / yr + rollover. Currently, (not including bariatric conference expenses) we have $39,098.24 used in 2006. The ABLS (Advanced Burn Life Support) conference- PNCC name is not on flyers or banners. As a sponsor, PNCC should have recognition on those items. Poor communication of our requirements as a sponsor were to blame. Vikki spoke to Julie Bostrom (conference lead) about this issue. Julie acknowledged this miscommunication and said that PNCC will receive recognition with online reg. from now on. Julie shared that this conference received Federal reimbursement for registration fees and speaker costs - $5000.00. Cost for PNCC are lodging of 10 staff members $79/night x 5 rooms x 2 nights’ and food for the day of conference. PNCC will provide approx.$3500.00 for airfare, lodging and catering. This PNCC committee agrees that we need to set up some standardized criteria to be followed if PNCC funds are used in a sponsorship role. We also need to set up a checklist of required information that solisitors of PNCC funds will follow prior to meeting with the PNCC committee. Terri Lewis, Karen Stanard, and Debbie Reif will work on a template/work instruction to cover this. They will present it to the next meeting. Debbie pointed out that it is immportant to spend appropriate PNCC funds prior to the next negotiations, as it could affect future PNCC funds. Ruth Ott, RN, OR nurse educator, presented her request for PNCC education money. This would be used for internship programs for 4-5 new OR staff. The “Peri-OP 101” opportunity begins this fall with 81 contact hrs and 9 months of internship (clinical) for each staff. Costs are $500.00 plus books + $750.00 total for each student. Ruth is asking PNCC to allow current OR RN’s to donate their individual portion of “unused” PNCC ed. funds to be used for these costs. She felt that PNCC has the authority to go above and beyond tha allotted money for special needs. The individual criteria for acceptance into the classes are: 1. each is a current hosp. emp.; 2. each would be interviewed by the union rep.; 3. orientation after class; 4. obligation for one year of work at SCMC following internship. Ruth was ased if she would check with other sources of income, ie.- grant $, vendors, foundation. PNCC committee had discussion and concluded that “transfering funds” from each RN’s allottment would be much to difficult to keep track of, and therefore the committee respectfully declined Ruth’s request. Lynda Enos RN,MS , is here to speak about ergonomics in our workplace. She is asking for the PNCC’s endorsement of the implementation of a hospital wide “No Lift” policy and Pt. / worker safety. Lynda has 30 hx in nursing and currently works with ONA , consulting about workplace layout/risk management/ employee health. She ws called by Theresa Kramer, a P.T. at SCMC, to work on improving the ergonomics at SCMC.. They see the PNCC as providing their approval/ energy/ encouragement needed to get by-in by the nurses. The PNCC comm. recommended they talk to Clinical Care management to set up priorities, then approach the administration for funding. the PNCC feels this is a need for SCMC and will be available to help in the future. Interim Staffing plan - All units have completed their acuity criteria. Education will begin with the AUM’s and relief AUM’s on all units. It was suggested to have laminated cards placed on each computer with that criteria on it. This wouls ensure that every one was using the same criteria. This is very important to validate and compare with the previous staffing plan. Demo day for Optibox will be May 10 and 11. Meeting adjorned at 11:30 am. Respectfully submitted by Terri Lewis and Karen Stanard. |
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| 3/9/2006 |
P.N.C.C. MEETING MINUTES MARCH 9,2006 |
| P.N.C.C. Committee meeting 3-9-2006 Present: Vikki Hickmann, Terri Lewis, Debbie Reif, Karen Stanard, Angie Streeter Guests: Linda Coats, Karen Hack, Collene, Sue Davidson Vikki reviewed what has been happening since our last meeting, 2-17-2006.: She met with Carol Valesquez and Nancy Moore on 2-24-2006. They discussed the work on the interum staffing plan. The UPC reps are working with their respective unit managers to form a 4 step interum acuity plan. They shall have them ready for review by March 30. Current business: Lynda Coats is attending to serve as our “staffing expert”. She has worked with several different staffing and acuity systems at SCMC for many years and can claify how the current plan actually works as well as her work on forming the updated 4 stage plan for her unit. Lynda informed us that Mary Demaris (SCMC Patient Care Support) was working to find a way to use Affinity to measure and adjust the units workloads. She was asked to do this by Nancy Moore and Carol Valesquez. Lynda feels tfe Affinity system is too lengthy and cumbersome. This would take too much nursing time on the units. The Staffing comittee is looking for new staffing software. Interium Staffing Plans reviewed: Currently, each units staffing / shift is derived from the Affinity staffing numbers and the AUM’s direct conversation with unit nurses. These 2 aspects are considered for the staffing at the unit level. Once an interium staffing system is decided on, there will need to be some time (possibly 2 weeks ) for education on the units. It may be possible to use some of the R.N. ‘s needing hour to do the education piece. This will be suggested to Nancy and Carol. Approx. 2 weeeks after the education period, there will need to be a review and validation of the interium plan. This validation process is usually done by both the staff nurse and AUM. Thier individual audits must match by 80%-90% in order for the system to be valid. Karen Hack and Angie showed us the Acute In patient Caregiver Matrix (see handout). They have 4 levels. Karen Hack feels that medical floor will be able to teach the new system without special training sessions and could be ready to “go live” by mid April. We will check with the other units for their timelines. Terry will talk with IMCU. Lynda will check with rehab. and Colleen. We will meet again on March 30,2006 to review all the unit interium plans . Meeting Adjourned. Respectfully submitted, Karen Stanard |
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| 2/28/2006 |
STAFFING COMMITTEE, DIRECT CARE RN MEMBERS |
| Date: February 18, 2006 Present: Angie Streeter (Medical), Kathy Menefee (Rehab), Sharon Walden (IMCU), Duke Sells (Medical), John Nangel, Cynthia Ingman (CCU), Lynda Coats (Ortho/Neuro), Debbie Griffith (OR), John Dockendorf (PCS), Karen Stanard (ER), Debbie Rief (Medical), Bruce Humphreys (Cath lab) ONA Staff: Sue Davidson, Kurt Willcox (briefly) Abbreviations: DCRN’s (direct care registered nurses, as described in the law) SC - hospital Staffing Committee\ OAHHS: Oregon Association of Hospitals and Health Systems (aka hospital association) I. Introductions, purpose and general background. (Kurt Willcox, Angie Streeter, Sue Davidson) Kurt recapped the meeting held the previous hour that was held with chairs of UBPCs. The background is that Nancy Moore has charged the UBPCs to develop their unit’s version of a 4 point staffing plan with the PNCC to be a resource to the UBPCs as they work on this. Initially, Nancy said that the UBPCs were to report back to Leader/Managers (LM’s), but communication broke down somewhere (BU is unsure about the level where the breakdown occurred) with some UBPCs doing nothing, others starting something. Meanwhile, the discussions and responses over what the specialties at SCMC will be between PNCC and Carol Valesquez have finally been completed. A decision has also been made to be sure that there will be always be a representative from PNCC at meetings of the SCMC Staffing Committee, once it starts meeting. The main purpose of these unit-based and Staffing Committee efforts is, of course, is to get it a more valid and reliable unit level staffing plan, and to increase the nursing hours per patient day (nppd). Angie wants to make sure that we keep in the spirit for new communication. II. Review A. Sue Davidson provided each attendee a folder which contains the following materials: * A copy of the HB 2800 side by side: far left column, the 2001 law; middle column: the rules related to 2001 law; and far right column, new language in law (2005). * A template for a Staffing Committee charter Source: built from a template on the NWONE web site for a hospital near Salem; Use: by direct care RN’s to ensure that the processes for meeting and deciding by the SCMC Staffing Committee create an equal partnership between DCRN’s and nurse managers *A list of references to nurse staffing on national specialty organization web sites; Source: web sites, date: 2006 Use: For units that have external standards; not required to use, but should be reviewed *A suggested template for making a complaint to the Oregon Health Division *Pamphlet and booklet from American Nurses Association B. Each component of the packet was reviewed and discussed. C. Terminology. Sue brought up the point that terms matter and a term that is frequently used by staff nurses at SCMC is “acuitize”. To those who use the term, it seems that they are referring to calculating how ill/sick the patient is, and from that, determining the nurse’s work load intensity. The most important part of the “acuitizing” is the nurse’s work load intensity. Sue suggested that nurses who will be on the SC be care to use the term they really mean. There are standardized definitions about this and other terms frequently used in nurse staffing and ONA will be preparing a list of accepted definitions for these that are used in the US. Another term that is being used is “hours per patient day”aka “hppd”. What also matters are the “nursing hours per patient day” aka (nhppd). Sue suggested that in the discussion about staffing plans, DCRN’s strive to leave what the actual nhppd is for their unit, and how that differs from hppd (something, non-direct care givers are included in this). III. Supporting DCRN’s who are on the SCMC SC A. ONA will be developing materials that will be sent out in blast e-mails on a 2 -3 weeks basis during this period of time. Some of the materials that are being developed are: *A summary of the agreements reached in meetings between ONA and OAHHS; *A summary of the meeting with the OHD (2/16/06) *Information about Optilink B. A list of the DCRN’s who will be on SCMC’s SC is posted on the ONA/SCMC website. The meeting adjourned at approximately 11:10 a.m. Respectfully submitted, Sue B. Davidson, PhD, RN, CNS Asst. Executive Director, ONA Nursing Practice, Education and Research |
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| 2/26/2006 |
MEETING OF UNIT BASED PRACTICE COMMITTEES |
| Oregon Nurses Association * 18765 SW Boones Ferry Rd., Ste. 200 * Tualatin OR 97062 St. Charles Medical Center PNCC-sponsored Meeting of Unit Based Practice Committees Date: January 17 , 2006 Site: SCMC Topic: Interim Staffing Proposal Present: Angie Streeter/Medical, Debbie Rief, Leanna (Critical Care), Christy (Rehab), Lynda (Ortho), Priscilla, Cynthia, Nancy/Med, Karen Stanard (ER), Melissa (ER); Duke Sells (Medical), Kathy (Rehab); John Dockendorf, John Nagel, Bruce Humphreys (Cath Lab), Sharon (IMCU), Ann Moller (RR). ONA staff: Sue Davidson, Kurt Willcox; I. Introduction: Sue Davidson gave a short description of the two activities that are taking place in the state with the ONA/hospital association meetings, and recently, the first rule making meeting held by the Department of Human Services (known as the health division). II. Unit based staffing plans A. Background: At the January Labor Management meeting, Nancy Moore indicated that administration would work on this, and later it was learned that she intended to ask the various unit based practice committees to begin reworking the 3-level system into a 4-level staffing system based on the proposal made in that meeting by Angie Streeter and Teri Lewis. It is anticipated that the results of the Health Division visit/response will be out by late Feb/early March. B. The goal of this meeting is to determine what progress has been made on various unit based practice councils, and to ensure that there is some similarity across the plans. C. Findings 1. Angie has determined that some UBPC’s have met, others have not and some do not understand what their task is. Given this situation, Angie feels that it is very important for each UBPC to have education related to the goal, and on how to convert what their unit staffing plan is from 3- to a 4 point system. 2. The other problem is no one is entirely certain about who the UBPC chairs are, thus making it more difficult to communicate with that group. 3. It appears that Nancy Moore needs to re-send her request for the units to develop their interim staffing plan to the UBPC chairs. 4. Angie was given a sheet from Optilink which provides some suggestions for a 4-point staffing system, but it is unclear whether this sheet of paper is meaningful since SCMC has not yet reviewed it’s intention to purchase Optilink with either the PNCC or the soon to be formed Staffing Committee. 5. Some UBPCs have taken action, e.g., changed their staffing plan by changing everything to 4 levels but without readjusting the 8 categories of interventions or by clustering interventions with the 4 levels. 6. Nancy Moore wanted to have feedback by January 31st. This date has passed with very little response largely because many of the attendees at this meeting had not even heard that they were supposed to be doing this. D. Discussion 1. Would UBPC’s be best to make the decisions on what goes under the 4 categories on their unit? Answer: Yes, they know the patient populations the best. 2. Is the goal that the UBPCs to decide the categories? No, four categories is what we are working with (low, mid-, mod, and high). 3. What about patients who require RN 1:1 or CNA 1:1? Currently, they are included in the staffing grid, but other places, 1:1's are moved out of the staffing grid for the whole shift. Answer: For this interim plan, move all the RN 1:1's and the CNA 1:1's out of the matrix of level x 8 categories of interventions. 4. What about ER where we don’t do this stuff? Answer: You are using external standards and this does not apply to you unless there is a problem with the staffing plan in your unit. 5. What about differences in the definition of each unit’s “low”, “mid”, “mod” or “high” acuity patient? Answer: This will be dealt with when the unit plans are developed. It is likely that there will be similarities that emerge but this won’t be known until this revision to the interim plan takes place. 6. In the old 5-point system, when you are “acuitizing” your patients, if the acuity fit mostly in the third level but there was one intervention cluster in the next level, the decision rules were that you could bump the patient’s acuity up to that level. Will this hold? Answer: Hope so. 7. How will this revision and creation of an interim staffing plan for each unit work if the reason that the hospital reduced the hppd for various units was the budget crunch? Answer: The answer to this question is complicated but in the end, staff nurses and others were telling the Health Division that the hppd is not sufficient to provide safe nursing care. Essentially, the group needs to set aside is worries about the budget and get busy on developing their interim plans to make staffing on their unit better. 8. What are the rationales for revision of the current 3-point staffing plan? Answers: LOS is longer and thus, nursing care needs extend over a longer period of time; there have been instances where delivery of nursing care has been unsafe and there are sentinel events which are known to have happened. Additionally, the 3-point staffing plan created a situation where it looked as if the patients and work load on various units was really not very high or very intense, not because it is really what is happening but because the 3-point system did not allow for a valid rating of a patient’s nursing care needs. This resulted in increased amounts of call off (the nursing care was not needed). 9 What is meant by “acuitizing” patients? Ans: what you have here is really a method of indicating the nurse’s work load intensity, e.g., how many and for how long are various nursing interventions needed to care for “x” number of patients on “x” unit. By using the term “acuitizing” you are really not accurately describing what is needed which is an accurate estimation of the nurse’s work load. Need to change the term that you are using. III. Action plan: A. Staff nurses in the UBPCs on each unit need to have a template for the “interim staffing plan” for their unit. B. PNCC will assume the role of consultant and mentor to various UBPCs as they develop their unit-based staffing plans. This can be accomplished because members of the PNCC are assigned to cover/liaison with various units at SCMC. C. PNCC needs to set up a communication channel with UBPCs. D. UBPCs need training in how to convert their current 3-level staffing plan to a 4-level staffing plan. For UBPCs which are functioning, PNCC may not be needed much, for those UBPCs which have not met for a long time, PNCC can work with them to create a staffing plan. E. Angie will ask Nancy Moore for the list of UBPC chairs and co-chairs on all of the units. In addition, she will request a copy of old 5-point system. F. A meeting needs to be scheduled for Nancy, Angie and Vikki to meet with the chairs and co-chairs to give them materials to complete this task. Additionally, SCMC needs to support the UBPC members on each unit to meet often enough to get the job done. The meeting adjourned at approximately 10 a.m. Respectfully submitted, Sue Davidson, PhD, RN, CNS Asst. ED, Oregon Nurses Association cc: attendees, Vikki Hickman, Shelly Lewis Leander, Angie Streeter, Kurt Willcox |
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| 2/15/2006 |
JANUARY MEETING MINUTES |
| Minutes 1-20-06 Members Present: Vikki Hickmann, Terry Lewis, Cynthia Ingman, Angela Streeter, Karen Stanard Members Absent: Debbie Rief Guests: Sue Davidson Guests not present: Carol Valesquez The original meeting agenda was set aside in order to focus our time on ideas for an interim staffing plan. These plans will be presented at the meeting to be held on Monday 1-23-06 between the Hospital and the SCMC Bargaining committee. The staffing Committee is currently being created . The Hospital Nursing Units have been brought together to form 8 groups : MSVS/SSC/IVTherapy/Infusion Rm; Ortho/Rehab; FBC/Peds/NICU; CCU/IMCU/Dialysis/Cardiac Rehab; ER; OR/PACU/MDU/SS; Radiology/Cath Lab; Pt Care Support/ On call/ CC floats. We discussed the role of the PNCC in relation to the Staffing Committee. It was felt that the PNCC should take a supportive role. Able to assist with any questions relating to HB 2800 or our contract relating to staffing , nursing care issues. We also felt we should have a PNCC member at each meeting . In addition we feel that the meeting should be open to the Bargaining Unit members as observers only. Suggestions for the Interim Staffing Plan were discussed. Pros and Cons for a # tiered, 4 tiered, or 5 tiered system were weighed. Several other important needs for proper acuitizing of patients and staffing were brought up : 1) revisit what does NOT work with the 3 tiered system, 2) give back the AUM hours (on nights), 3) give extra hours (not just steal them from other pt’s) for behavioral problem patients, $) Acuitizing of pt’s should be done by the “bedside RN” , not the AUM. Terry Lewis and Angela Streeter, and Sue Davidson kindly agreed to meet over the week end to solidify these suggestions into an interim staffing proposal. Many thanks to your extra work! The Oregon Health Divisions investigation at St Charles 1-9 thru 1-13 which discussed the staffing matrix change which occurred as a potential violation of HB 2800 August 2005 , included interviews with many RN’s involved in this issue. The Health Division was also present to listen to the Administration give their interpretation of this occurrence during a few of their many “Forum “ presentations. Many RN’s that took part in the investigation felt it was done in a fair and balanced way. The Meeting Adjourned at 12:00 , respectfully submitted, Karen Stanard R.N. |
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| 12/10/2005 |
DECEMBER 1ST PNCC MEETING MINUTES |
| Members Present: Vikki Hickmann, Karen Standard, Cynthia Ingman, Angela Streeter, Terri Lewis, and Nichole Ryan. Absent: Debbie Rief -PNCC reviewed the surveys completed by RN’s and surveys done by members of the AUM staff at the hospital. A letter to the Oregon Health Division was prepared and reviewed by ONA and PNCC. This letter looked at the differences in the interpretation of HB2800, by both the hospital and the direct care nurses, asking them for a review of these differences. -PNCC will have an educational class pertinent to PNCC development on December 8, 2005 from 2-330PM. Early that day, ONA will sponsor education for the bargaining unit relevant to House Bill 2800 from 9-12 AM in the Sister Ann Rita. -Patricia Fernald our representative will be stepping down from PNCC. Thank you, Patty for all your service and time. We will miss you!! -Nichole Ryan will be taking over the position of secretary. Karen Standard will be filling in during her absence. -Cynthia Ingman will be assisting our current educational reimbursement/ treasurer Debbie Rief. -A sign-up sheet was started for members to sign up for orientation times. This orientation is to educate the new nurses joining our facility. -A tentative meeting schedule was made and this information will be released as soon as meeting rooms have been confirmed by the hospital. Just a reminder to all bargaining unit nurses that the first half an hour of all meetings is open to all bargaining unit members to attend. This will allow you to ask questions regarding reimbursement, nursing practice concerns affecting you in your area, or to come see what we are all about. |
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| 10/3/2005 |
PNCC MEETING MINUTES |
| Present: Patty Fernald, Angie Streeter, Vikki Hickman, Debbie Rief, Cynthia Ingman, Karen Stanard, Terri Lewis Absent: Nichole Ryan, Marci Allison ONA staff: Sue Davidson, Kurt Wilcox Guests: Nancy Moore, Carol Valesquez, Shelly Lewis-Leander ** Vikki reminded everyone the realm we’re chartered to work in, differentiating between labor and direct patient care issues. PNCC’s focal point is activities that affect the care patients receive and the care nurses give. ** Discussed co-sponsorship of a burn workshop presented by Julie Bostrom. The committee determined that more information was needed before a decision could be reached. ** The review of national “Gold Standards” related to clinical practice requirements across specialty organizations is complete. A summary of the findings will be presented to Nancy Moore along with recommendations for education from the PNCC. ** PNCC would like members who attend UPC Quarterly Chair meetings, Patient Care Leadership meetings, and Evidence Based Practice meetings, to share information obtained at these meetings, with the PNCC committee. ** Nancy Moore and Carole Velasquez presented to the group, how, and why, the new patient classification (acuity) system came into existence. They answered questions regarding HB2800 compliance, as well as nursings contribution to the budget reduction. PNCC will meet to discuss the outcome and actions to be taken. ** PNCC would like to remind everyone to look for, and fill out the online survey that will be out shortly, on the stcharlesnursing.org website. The intent is to show the impact of the new patient classification system on patient care. PNCC would also like to remind everyone to use the ONA staffing requested and document form (SRDF) if you determine that patients and/or staff are placed in an unsafe situation. It can be filled out on line (oregonrn.org). We can only present an argument of unsafe care practices if we have facts to support it. ** Continue to send all education reimbursement requests to PNCC at CHL’s mailbox, via inter-office mail. ** PNCC has OPEN meetings. For the first ½ hour of each meeting, all are welcome to come and attend. Present your own concerns, ideas, or just come see what we do. Next Meeting: November 8th 12-2 PM in CRH |
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| 9/12/2005 |
SEPTEMBER MEETING MINUTES |
| Present: Vikki Hickman, Chair; Nicole Ryan; Debbie Rief; Jessie, Karen Stanard; Kathy Phillips; Gray Cox; Angie Streeter Guests: Julie Bostrom ONA staff: Sue Davidson, Kurt Wilcox Adoption of minutes was waived. I. PNCC co-sponsorship of burn workshop A. Julie Bostrom is asking the PNCC to co-sponsor a health professionals workshop on burns at SCMC. She recommends an 8 hour class which is taught by a health professional group from Utah. She believes this 8 hour class is needed because there is confusion among paramedics and others in treating a burn injury in the first 24 hours. The class has a limited capacity, e.g., 35 registrants. The course has been approved by the AACN (critical care nursing association). A rough estimate is that the course will cost $437/person. Examples of patient groups with whom this care is needed were given e. g., fires, explosions, electrical burns, lightening, motorcyclists who get abrasions which act, clinically, like burns. The faculty who give the class present the latest type of care; pain and fluid treatment parameters; assessment of need for intubation and other burn-related topics. The class results in a recognition of the attendees competency in burn care. She has assessed interest in the class among outlying practitioners including Air Life people in the area including Redmond, Bend; Burns did an ABLS course in the recent past. The major expense of the class is to get the course faculty to Bend. B. Questions: 1. What would the costs be? How much of the costs would be offset by registration? Answer: There is no income to the teaching team for this. Half of the money goes to American Burn Association and the other half is used to defray expenses of the course faculty. 2. How many burn patients remain for care at SCMC? Ans: Don’t know now many burns are kept. However, this course is not directed to care given in the recovery phase. 3. What is the renewal time for “certification” in burn care? Ans: Julie was not sure but thinks it may be 6 years. 4. How do you renew? Ans: does not know. 5. What if more than 35 people register? Ans: The faculty would stay another day and would charge for that. 6. How do you deal with expenses of the faculty? Ans: use typical per diem costs. Overall, group feels there is interest and it is fairly wide spread between and among various health care professionals including nursing. C. Discussion 1. One way to co-sponsor this is to ask the SCMC Education Department to do the ground work and foot the bill and reimburse them for costs not covered by registration. However, the Education Department doesn’t usually foot the bill; they figure out the costs and split the tuition between the expected number of registrants. However, Education Department rarely makes any money. 2. Current yearly PNCC budget is $110,000; to date, about $65,000 has been spent, and there are carry-over monies of about $25,000 from the previous year. 3. It was suggested that there be a price break for SCMC nurses and a higher registration cost for others. 4. Homeland Security dollars might be another source to support the course cost. 5. There is consensus in the group that the course would be filled and they can count on at least 35 people. D. Action plan: 1. Julie will a. Figure out costs and talk with Salt Lake City faculty. b. Confirm interest in the course from various groups, e.g., paramedics, Air Lift; Marty; Helenka, SCMC physicians. c. Talk with the SCMC Education Dept. find out what typical speaker/presenter costs are and how those are handled. d. Work with Education Committee. e. Talk with various drug and other potential corporate support e.g., fertilizer plants. 2. PNCC will make the co-sponsorship decision next month. II. Division of tasks among PNCC members A. There are quite a few meetings that are happening and SCMC is asking that members of the PNCC attend. 1. UPC quarterly meeting: 1 hour every three months Who: Patti Fernald 2. Patient Care Leadership meeting: once per month Who: Angie Streeter 3. Evidence based practice meeting: Who: Nicole Ryan 4. Review of unsafe staffing form (SCMC) Who: Nicole Ryan, Vikki Hickman, Karen Stanard Project: The SCMC form needs to be reviewed even though it is more related to scheduling than issues surrounding nurse staffing, and a thank you card sent to the staff nurse. Nichole has made a spread sheet of information from each report. It was noted that these reports may have an elapse time (from event to report getting to PNCC) of as much as 6 - 7 months. B. Sue Davidson suggested that the group review the function of each of these meeting and ensure that the PNCC’s goals for the year are being met through attendance at these meetings. III. Education requirements for various specialty units. The issue here is that there are no standardized recommendations related to clinical practice requirements across specialty organizations. For example, Emergency Nurses Association may vary from what the Association of Critical Care Nurses says. This makes it difficult for practicing nurses at the facility level (and committees such as PNCC) to ensure that nurses who practice in these various clinical areas are meeting national standards in terms of preparation to practice. No action was taken on this issue. IV. Change in patient classification system A. Issue: A significant change in the patient classification (acuity) system and associated nurse staffing with limited (if any) discussion and consultation with staff nurses at SCMC. B. Action plan 1. Need for evidence of impact. Because the current unsafe staffing form is insufficient, and because there is a need to understand the impact of the new system, a letter to all SCMC nurses (Bend, Redmond) will be sent which contains a copy of the ONA Staffing Documentation and Request form, asking the staff nurse to fill out (hard copy or the web site of ONA) and file (FAX, mail, direct hand off to PNCC) the form with ONA during a six-week period of time while this issue is resolved. Action: *Vikki will create a letter to the nursing staff explaining what PNCC is doing to respond to the change, and asking nursing staff to fill out the SRDF form when appropriate as a means of evaluating the impact of the change. *ONA will ensure that the mailing of a letter and an SRDF goes out in a timely fashion to staff nurses. *PNCC members were urged to keep in contact with their respective units so that staff nurses have a contact to reach regarding impact. 2. Need to document flaws in the new 3-point system: there was discussion about the differences in how this new system has been rolled out, and how it appears to be “rigged” to make rating a patient always come out in the moderate nursing care level, e.g., it doesn’t matter what acuity you enter, the patient never is rated as a “1" or a “5". This discovery has lead staff nurses to stop inputting the data about patient acuity. Other examples of the impact of this new system were cited such a sign on a unit which says “All patients will be classified as a 3". The outcome of all of this is that the nurses feel that SCMC no longer cares about patients. Action: *Sue Davidson handed out a draft of a web-based survey for staff nurses to complete at SCMC: Bend (and a hard-copy for SCMC: Redmond) which will capture data related to problems and impact of the new system. There was limited discussion of the survey and refinement of it will take place between Vikki, Kurt, and Shelley before the survey is launched. 3. Process of changing patient classification. It appears (and will be confirmed through a survey) that, although SCMC has indicated that they are working with the PNCC and ONA to develop this change and no one (including ONA) is opposed, there was little to no substantive interaction with ONA on the change in the patient classification system. Action: *The PNCCs/BU leadership at SCMC (Bend and Redmond) will send a letter to Nancy Moore asking how she complied with HB 2800 in making this change, and also asking what contribution nursing is making to the budget reduction. Nancy Moore, Carol Valesquez and Mary Demaris will be invited to attend the October 3rd PNCC meeting to explain the goals, processes and time frame for the change in the patient classification system. The letter will indicate that if there is no response, the PNCC will file a complaint with the Oregon Health Division. *A general meeting of SCMC staff nurses will also be held once the PNCC meeting with Nancy et al has been held. *Nancy Moore, Carol Valesquez and Mary Demaris will be invited to visit various nursing units to directly observe the impact of the patient classification change. |
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| 8/2/2005 |
PNCC MEETING MINUTES |
| Present: Deborah Rief, Patty Fernald, Angie Streeter Absent: Cynthia Ingman, Nichole Ryan, Marci Allison, Vicki Hickman, Kerry Spinney ** Deborah Rief updated PNCC on its financial status. ** PNCC was asked to support contract, and non-contract RNs for a fetal heart monitoring class. PNCC will support only contract RNs. ** CONGRATULATIONS to Andrea Smith, RN on Ortho-Neuro. She is the winner of PNCC’s logo contest, and will receive a $100.00 gift certificate to “The Old Mill District”. Thank you Andrea, and to everyone whom contributed. ** Continue to send all education reimbursement requests to PNCC at CHL’s mailbox, via inter-office mail. ** Remember, PNCC now has OPEN meetings. For the first ½ hour of each meeting, all are welcome to come and attend. Present your own concerns, ideas, or just come see what we do. Meeting schedule for 2005: September 12th 9-11 in CRE October 3rd 9-11 in CRE November 8th 12-2 PM in CRH |
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| 6/20/2005 |
PNCC MEETING MINUTES FOR JUNE 20TH, 2005 |
| Present: Nichole Ryan, Patty Fernald, Vikki Hickman, Angie Streeter Absent: Deborah Rief, Cynthia Ingman, Marci Allison, Kerry Spinney ** Reviewed individual findings for nursing certification “standards”. ** PNCC continues to look at the committee structure and position replacements. ** Nancy Moore presented the “Cascade Healthcare Community 2005--2006 Patient Care Focus" “Patient Care Financial Crisis Plan”. ”**Continue to send all education reimbursement requests to PNCC at CHL’s mailbox, via inter-office mail. ** Remember, PNCC now has OPEN meetings. For the first ½ hour of each meeting, all are welcome to come and attend. Present your own concerns, ideas, or just come see what we do. Meeting schedule for 2005: August 2nd 12-2 PM in CRE September 12th 9-11 in CRE October 3rd 9-11 in CRE November 8th 12-2 PM in CRH |
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| 6/3/2005 |
PNCC MEETING MINUTES FOR JUNE 3, 2005 |
| Present: Nichole Ryan, Patty Fernald Guests: Kathy Phillips-Medial Floor UPC Chair, and Sue Davidson –ONA Absent: Deborah Rief, Cynthia Ingman, Vicki Hickman Marci Allison, Kerry Spinney ** Draft of survey of nurses on the staffing plan reviewed for content and presentation. The purpose of the survey is: -To collect information from staff nurses on unit based practice councils and others to determine what the current status is of compliance on that unit with the staffing laws. -To critique the St. Charles Work Instruction on nurse staffing. -To provide recommendations to St. Charles on the current staffing plan. The survey will be posted to the St. Charles Nursing web site through July and August. Please encourage your fellow nurses to complete this survey. How our units are staffed affects our patients, each and every nurse, and the community at large. ** Briefly discussed the plan and progress for reviewing nursing certification “gold standards”. This is to be discussed at our next meeting. ** Discussed bringing the CE Course “Inflammation, The Silent Killer” to St. Charles sometime this fall. Funding and availability of funds is to be reviewed and verified. ** Reviewed membership issues and concerns. Nichole Ryan is stepping down from the PNCC Chair, but wishes to continue to serve as a committee member. PNCC will look into using “alternates” in the committee structure. ** ONA is looking into bringing a conference on Pain, October 26 to the River House. This will meet the health care practioners CE requirements recently set by the Oregon State Board of Nursing. Look to the ONA web site for more information. **Continue to send all education reimbursement requests to PNCC at CHL’s mailbox, via inter-office mail. ** Remember, PNCC now has OPEN meetings. For the first ½ hour of each meeting, all are welcome to come and attend. Present your own concerns, ideas, or just come see what we do. Meeting schedule for 2005: June 20th 9-11AM in CRE - Administration Invite August 2nd 12-2 PM in CRE September 12th 9-11 in CRE October 3rd 9-11 in CRE November 8th 12-2 PM in CRH - Administration Invite |
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| 5/2/2005 |
PNCC MEETING MINUTES FOR MAY, 2005 |
| Present: Angela Streeter, Patty Fernald Special Guest: Sue Davidson - ONA Absent: Nichole Ryan , Deborah Rief, Cynthia Ingman, Vicki Hickman, Marci Allison, Kerry Spinney ** Staffing concerns discussed. ** ONA’s 2005 Legislative Agenda presented by Sue Davidson. ** Survey created, regarding review of the written SCMC – Bend nurse staffing plan. ** Please continue to send all education reimbursement requests to PNCC at CHL’s mailbox, via inter-office mail. ** Remember, PNCC now has OPEN meetings. For the first ½ hour of each meeting, all are welcome to come and attend. Present your own concerns, ideas, or just come see what we do. Meeting schedule for 2005: Meeting places for July through December to be announced. May 2nd 12-2 in CRB September 12th 9-11 AM June 3rd 9-11 AM in CRE October 3rd 9-11 AM July 20th 9-11 AM November 8th 12-2 PM August 2nd 12-2PM December 5th 5-7 PM |
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| 4/8/2005 |
PNCC MEETING FOR APRIL 8, 2005 |
| Present: Nichole Ryan, Deborah Rief, Patty Fernald, Marci Allison, Kerry Spinney Absent: Angela Streeter, Cynthia Ingman, Vicki Hickman ** Welcome Kerry Spinney, our new PNCC member representing the Surgical Specialty Cluster ** Meeting times for July – December 2005 chosen (see below). ** PNCC has created and instituted a form that acknowledges receipt and review of Staffing Incident Reports filled out by nurses. The form also thanks nurses for their time and effort to document what they perceive as unsafe events. The team discussed real, and potential barricades to nurses filling out these forms. ** Flyers for PNCC’s logo contest are complete and distributed. The contest is limited to bargaining unit members only. Winner gets a $100.00 gift certificate to the shops at the Old Mill. Deadline is April 25, 2005. Look for the yellow flyers in your department for the rules. ** Discussed shortage of nurse resources, and ideas to counteract. Discussed “sitters”, Mountain View High students, cadet nursing program, and health occupation classes. Will discuss “scope of practice” of these resources with Carol Valasquez. ** Staffing incidents reviewed. ** Miscellaneous reimbursement questions addressed. ** LERC – Central Oregon Leadership School opportunities presented. Current classes available are Advanced Grievance Handling, and Building Unity and Power. For more information contact http://www.uoregon.edu/~lerc/index.html ** Review of written SCMC – Bend nurse staffing plan initiated. ** Please continue to send all education reimbursement requests to PNCC at CHL’s mailbox, via inter-office mail. ** Remember, PNCC now has OPEN meetings. For the first ½ hour of each meeting, all are welcome to come and attend. Present your own concerns, ideas, or just come see what we do. Meeting schedule for 2005: Meeting places for July through December to be announced. May 2nd 12-2 PM in CRB September 12th 9-11 AM June 3rd 9-11 AM in CRE October 3rd 9-11 AM July 20th 9-11 AM November 8th 12-2 PM August 2nd 12-2 PM *December 5th 5-7* * No open meeting in December* |
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| 3/24/2005 |
PNCC MARCH 11TH MEETING |
| Present: Angela Streeter, Cynthia Ingman, Nichole Ryan, Marci Allison, Debbie Rief. Absent: Vikki Hickmann, Patricia Fernald. -Opening discussion for our meeting started with the hospitals plans for nurses’ day. Cynthia Ingman attended administrations meeting for the planning of nurses’ day. The gifts to nurses will be announced in a letter from Nancy Moore that will be sent out to the nurses’ homes. Pictures of nurses will be taken on both day and night shifts to make collages for the lobby. SCMC- Bend will routinely acknowledge nurses with advanced degrees and certifications in the caregiver connection yearly. Katie Kimmel will be responsible for the list. Big Banner ads will be taken out for the local newspaper. -PNCC will hold a logo contest. For a logo that will belong to only our PNCC. The contest will be limited to only bargaining unit members. The logo will have a primary shape of a triangle. The winner will get a $100 gift certificate. -PNCC will start attending nurses’ orientation. A script for orientation was decided on. We will use our charter along with a few brief descriptions such as… *** Www.stcharlesnursing.org as the median to obtain PNCC minutes. ***Review the reimbursement process and where all PNCC forms and work instructions are located. ***Let new members know about the open forum. ***List current members and the units they represent. -Kerry Spinney, from SSC, will be joining PNCC as the current surgical representative. We are looking forward to meeting her!! -PNCC continues to update the ONA books in every department with new PNCC information. Look for the updates in your area soon. -C.N.A. shortages have impacted the nurse-staffing plan at SCMC-Bend. COCC is losing funding for their C.N.A. program. Will follow up on a possibility of a program involving Mountain View High School students. -PNCC will discuss with the Center for Health and Learning about Pain education to be offered here at the hospital. -We will be discussing the nurse-staffing plan at SCMC-Bend at our next meeting. Please join us Friday April 8th from 9-930 AM in conference room D. |
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| 2/7/2005 |
PNCC MEETING MINUTES FOR FEBRUARY 7TH, 2005 |
| Present: Marci Allison, Deborah Rief, Angela Streeter, Cynthia Ingman, Nichole Ryan Absent: Patricia Fernald, Vikki Hickmann Administration Present: Carol Velasquez *Carol Velasquez presented a overview of information that she has compiled from Staffing Incident forms and staffing usage of traveler and agency usage. *Discussion about the shortage of C.N.A.’s throughout the hospital and the impact this has on the nurse staffing plan. The role of sitters for CNA 1:1 was also discussed. *Recommendations about further EMR education compiled and the list will be sent to Karen Fitzgerald. *Discussion activities for Nurses Day. Cynthia will attend a meeting with the administration committee to represent PNCC. PNCC has set up a sub committee that will come up with an activity for nurses day that will be PNCC sponsored. *PNCC will start speaking to new RN employees during hospital orientation. A sign up sheet was made and passed around. Next meeting, guidelines for this process will be designed to assist those doing the new hire orientation. *PNCC’s work instruction, wage reimbursement form, and application for reimbursement are in need of revision. Debbie will oversee the changes that are needed. *Will start election process on surgical floor for new PNCC member. |
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| 1/3/2005 |
PNCC MEETING MINUTES |
| PNCC Meeting Minutes for January 3rd, 2005 Present: Nichole Ryan, Cynthia Ingman, Patty Fernald, Deborah Rief, Vicki Hickman, Absent: Angela Streeter, Marci Allison Special Guest: Sue Davidson – ONA ** Treasury update from Deb Rief. Reviewed education reimbursement requests, and the need for clarification of these work instructions and policies. Deb is compiling a list of PDA software that PNCC has approved, and will present this to administration. ** Prioritized 2005 PNCC goals, and discussed how we planned to achieve these goals. ** Began looking at Nurse Day options for PNCC to honor nurses. ** HB2800 Education Class – 8.0 contact hours available. FREE to all unit bargaining members. Lunch will be provided. Information will be posted to the hospital bulletin boards. RSVP to PNCC at CHL via interdepartmental mail, or PNCC@stcharlesnursing.org if you’re interested. ** Work has begun to develop certification requirement recommendations for each nursing unit. ** Membership drive for a representative from the surgical cluster continues. If you’re interested, or know someone who is, please email us at PNCC@stcharlesnursing.org. ** Please continue to send all education reimbursement requests to PNCC at CHL’s mailbox, via interoffice mail. ** Hospital Administration quarterly meeting will occur during our February meeting. ** Remember, PNCC will now have “OPEN meetings”, beginning in January 2005. For the first ½ hour of each meeting, all are welcome to come and attend. Present your own concerns, ideas, or just come see what we do. Meeting schedule for the first six months of 2005 are: January 3rd from 12-2PM in CRB February 7th from 12-2PM in CRB March 11th from 9-11AM in CRB April 8th from 9-11AM in CRD May 2nd from 12-2PM in CRB June 3rd from 9-11AM in CRE |
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| 12/6/2004 |
PNCC MEETING MINUTES |
| PNCC Meeting Minutes for December 6th, 2004 Present: Nichole Ryan, Angela Streeter, Cynthia Ingman, Marci Allison, Patty Fernald Absent: Deborah Rief, Vikki Hickman Special Guest: Sue Davidson – ONA ** Discussed EMR concerns. Sue Davidson gave us a referral for questions regarding “delegation and documentation” principles. ** Reviewed education reimbursement requests and our current policy. ** Hospital Administration quarterly meetings will occur at our February and June meetings. ** Chose 2005 PNCC goals: 1) Sponsor 2-3 selected educational pieces on topics of interest to bargaining unit members. 2) Revise the current PNCC work instructions (W18003) for educational reimbursement. 3) Complete the survey of NICU staff nurses and respond to their concerns. 4) Analyze and review staffing incident forms. 5) Evaluate the staffing incident procedure and effectiveness. 6) Find permanent housing for PNCC activities. 7) Increase bargaining unit members’ participation in PNCC. 8) Validate quality control issues regarding PDA software that PNCC approves. ** Membership drive for a representative from the surgical cluster continues. We hope to have someone on board by January. If you’re interested, or know someone who is, please email us at PNCC@stcharlesnursing.org. ** Sue Davidson, as ONAs’ Head of Professional Services informed us of 2 projects: a “Safe Lifting” project that works with staff nurses, as well as a Health Division project looking at immunizations and hospital standing orders. Sue discussed House Bill 2800s intent to assign nurse staffing based on acuity and intensity. She supplied us with information to review, regarding evaluating a written staffing plan. ** Due to the implementation of EMR, PNCC will be extending the yearly deadline for funds. This is a ONE-time extension of our December 15th deadline. We will be extending the deadline to Sunday, December 26th for all requests to be obtained. If your request is not obtained on the 26th your request will be processed for 2005. ** Remember, PNCC will now have “OPEN meetings”, beginning in January 2005. For the first ½ hour of each meeting, all are welcome to come and attend. Present your own concerns, ideas, or just come see what we do. Meeting schedule for the first six months of 2005 are: January 3rd from 12-2PM in CRB February 7th from 12-2PM in CRB March 11th from 9-11AM in CRB April 8th from 9-11AM in CRD May 2nd from 12-2PM in CRB June 3rd from 9-11AM in CRE Happy Holidays to everyone! |
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| 11/22/2004 |
PNCC MEETING MINUTES |
| Present: Nichole Ryan, Angela Streeter, Patty Fernald, Marci Allison, Cynthia Ingman Absent: Deborah Rief, Vikki Hickman ** Darci Myers is stepping down. ** PNCC continues to seek a representative from the surgical cluster. We plan to hold an open election for this position. Anyone interested, please contact one of the above representatives, or email us at PNCC@stcharlesnursing.org ** PNCC’s participation in the staffing incident report process was reviewed. PNCC will now receive and review these reports on a monthly basis. Nurses are asked to fill out both, ONA and the hospital forms. These forms, and a guideline can be found in the units’ ONA binders. ** The new contract language, changes, and its’ direct affect upon the PNCC was reviewed. ** PNCC will now have “OPEN meetings”, beginning in January 2005. For the first ½ hour of each meeting, all are welcome to come and attend. Present your own concerns, ideas, or just come see what we do. ** ONA unit binders will be updated. A new form will be added for nurses to be able to keep track of their own education reimbursement allotments and balances. This is intended to minimize the numerous requests for this information that PNCC gets weekly. ** The committee continues to look at ways to recognize nurses with advanced certifications. ** The PNCC charter was reviewed and finalized. ** The NICU survey has been finalized. Marci Allison will present and disperse this form to the NICU unit. ** PNCC discussed December’s agenda and 2005 goals. We’re looking forward to a productive year. ** Please continue to send all education reimbursement requests to PNCC at CHL’s mailbox interoffice mail. ** PNCC’s meeting dates and times are set for the next 6 months. Information on where these meetings will be held will follow. ** PNCC will review the certifications required by the hospital for nursing in each unit and make a recommendation regarding any changes to these requirements to the senior Vice President, Clinical and Healing Services by July 1, 2005. Meeting schedule for the first six months of 2005 are: January 3rd from 12-2 April 8th from 9-11 February 7th from 12-2 May 2nd from 12-2 March 11th from 9-11 June 3rd from 9-11 Meeting place to be announced. |
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| 9/15/2004 |
PNCC SEPTEMBER 8, 2004 MEETING |
| ** Nancy Moore and Carol Velasquez attended the quarterly management meeting. ** Carol Velasquez presented a quick overview of data that she had compiled from Staffing Incident Forms. ** Discussed PNCC education reimbursement trends. Need to look into external reference verifications (quality control) of PDA software that PNCC is approving for reimbursement. ** Discussed better ways to communicate educational offerings to RNs. Will continue to utilize current unit posting techniques, and look at options for obtaining an RN group email. ** Are looking into ways to increase professional educational offerings, as well as recognize those nurses that carry extra credentials. ** Search for an 8th member continues. Currently, no one is representing the OR and/or Surgical Specialty units. ** Are researching forming a PNCC charter. ** Auxillary members will continue to be eligible for PNCC education funds. ** Remember to send all education reimbursement requests to PNCC at CHL’s mailbox (interoffice mail). ** PNCC will NOT have a meeting in October due to EMR implementation. |
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| 8/18/2004 |
PNCC AUGUST 9TH, 2004 MEETING |
| **Continued to look at Staffing Incident & Staffing Request and Documentation forms and current practice. **Revision of informative sheet in ONA book done. This will be sent to Sue Davidson. **Will plan for a quick overview of data compiled from Staffing Incident Forms to occur at PNCC Quarterly Meetings. Carol Velasquez will be presenting the information to the group. **Will look at the chair and co-chair of PNCC to do monthly updates with Carol and visits to staffing office to review reports. **Will discuss with Sue Davidson how other PNCCs in the state, track and review there staffing incident information. **PCCN certification has been officially applied to the PNCC work instruction list. **Vote obtained to help cover the expenses of a fetal monitoring class for the nurses in FBC. **Continue our search for new members we are currently at 7 members. Looking for membership from the O.R. and Surgical Specialty units. **PNCC is looking at developing a procedural book to outline current practice of the committee. **PNCC will NOT have a meeting in October due to EMR implementation. **Our next meeting is September 8th 1200-1400 in CHL Classroom B. This will be our quarterly meeting with Management. |
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