Sammie Mosier, DHA, MA, BSN, NE-BC Senior Vice President and Chief Nurse Executive We are halfway through 2023, and I am proud and excited of the work we have completed over the last six months. One of the ways we are advancing the nursing practice is through our research initiatives. We reached several research milestones and look forward to several upcoming opportunities. Nurse-led, multi-site research: Nurses from HCA Healthcare were invited to present results of HCA Healthcare’s recent National Posttraumatic Growth Study at two national conferences and one international conference and delivered a podium presentation at this year's upcoming ANCC Magnet® Conference discussing the use of ANCC’s newly-released multi-site playbook for their study. This study was the largest study of its type and demonstrates a new era of nursing practice in the industry. The study focused on ways nurses grew and adjusted as they worked through the pandemic. This study is exciting because it aligns with our focus on nursing wellness. Driving the science around nurse-led strategies for preventing NV-HAP: Nurses at HCA Houston Healthcare Clear Lake, in collaboration with our new Director of Nursing Research, are getting ready to launch a study investigating barriers and strategies for meeting mobility and oral care targets as part of our enterprise-wide Non-Ventilator Hospital Acquired Pneumonia initiative. The nurse-led study, slated to start later this summer, will be one of the first to look not only at whether barriers differ between providers working in different care settings (e.g., Med/Surg, ICU) and disciplines (e.g., RN vs. PCTs vs. PTs), but will also look at proposed solutions. This is especially exciting as we partner with the CDC and have the ability to set industry standards in this area. Using enterprise data to build the science around HAI risk: Earlier this year, a team from HCA Healthcare published an analysis looking at the incidence of Healthcare Care–Associated Infections (HAIs) Among Hospitalized Patients with COVID-19” in the JAMA Open. The retrospective study, which included data from nearly five million hospitalizations over a two-year period, found that while rates of HAIs were almost three times higher for patients with COVID, while the incidence of HAIs in non-COVID patients was relatively flat, contrary to findings from smaller studies. Nursing special issue of HCA Healthcare journal focused on nursing sensitive indicators (NSIs): In another first for nurse-led research at HCA Healthcare, nurses from both inside and outside HCA Healthcare will be invited to submit research, quality improvement and evidence-based practice projects for an upcoming Nursing Special Edition of our popular, peer-reviewed HCA Medical Journal. The nursing issue, slated for release in 2024, will focus on showcasing emerging strategies, innovative care models, decisive evidence and dispelling myths on how to prevent falls, hospital-acquired pressure injuries (HAPIs), NV-HAP and other nursing sensitive indicators. In future editions of this newsletter, we will request any submissions of papers, so stay tuned. Your commitment to improving nursing practice and ensuring our patients have great quality outcomes is inspiring. Please continue to use your voice through your team meetings, engagement feedback, and shared governance councils to advocate for your needs. Thank you for the work and passion you bring to every patient! Nursing Strategy Advocacy and Leadership Staffing and Care Team Support Education and Academic Partnerships Professional Practice Patient-specific medication transfer best practice One of the most common medication administration interruptions occurs when patients, who have been transferred between floors, have missing patient specific medications. To prevent this, ensure you send patient-specific medications with the patient upon transfer. When medications are missing, this can create backups for other nurses and pharmacy colleagues. Avoid phone calls during medication administration Outside of emergency calls, no calls should be taken or placed while at the Pyxis machines or while actively scanning/administering meds to the patient. All colleagues are responsible for protecting medication administration from interruptions. Use independent double checks to prevent medication errors The use of independent double checks (IDCs) will prevent medication errors and provide layers of protection for all caregivers. IDCs should be performed prior to the administration of certain high alert medications (as indicated by hospital policy). If the double check is conducted independently, it reduces the risk of confirmation bias that may occur if the same person prepares and checks a medication, as they likely will see only what they expect to see, even if an error has occurred. Subcutaneous insulin and heparin have been removed from the HCA Healthcare Sample High-Alert Medication and Look-Alike Sound-Alike Medication Policy In the “How to” Guide for Insulin Medication Management, the ISMP Guidelines for Optimizing Safe Subcutaneous Insulin Use in Adults report that, “An independent double check of every subcutaneous insulin dose is not an optimal strategy for detecting errors, especially when used in isolation of other safety measures…” is included. Save the date: Walk in Your World On August 4, a “Walk in Your World” opportunity for senior leaders to round with nurses at facilities throughout the enterprise. During this time, facility, division and corporate leaders will spend approximately four hours rounding with direct care nurses. The goal is to see what is working well, where there are opportunities and get feedback from our colleagues. Welcome Chief Clinical Learning Officer Welcome to Peter Lindquist, DNP, RN, NEA-BC as HCA Healthcare’s new Chief Clinical Learning Officer. Peter brings a legacy of successful leadership and operations experience to the role. He joined HCA Healthcare in 2018 leading the corporate advocacy and leadership agenda and then assumed Division Chief Nurse Executive roles in MidAmerica as well as North Florida. Peter will provide leadership and successful operations for clinical education, including the expansion of HCA Healthcare’s Centers for Clinical Advancement from 15 to 34 centers over the next three years. This new position will bring a significant focus on partnering with clinical education leaders from Galen College of Nursing, Graduate Medical Education and other educational partners and stakeholders in our communities. Leadership Connection Series video The Leadership Connection Series is a quarterly video series featuring HCA Healthcare CEO, Sam Hazen and leaders from across the enterprise discussing our organization’s goals and strategic priorities that positively impact our patients, colleagues and communities. In this inaugural episode, Sam sits down with Jen Berres, chief human resources officer, and Sammie Mosier, senior vice president and chief nurse executive to discuss recruitment and retention at HCA Healthcare, as well as our organization’s significant investments in colleague and nurse engagement. Career pathway profile Jamie Hernandez is the Interim Vice President of Operations. Read more about Jamie’s career highlights here. Brian McAdams is the manager for the Emergency Department Unit of Distinction. Read more about Brian and his career here. Stay informed about your benefits Get updates by email: Log on to HCAhrAnswers.com and click Benefits: HCA Rewards Click BConnected and click on your name at the top of the screen Update email address, if needed Click the Communications tab and choose the delivery method for each category Click the Login & Recovery tab to add your email address for password resets Download the HCA Rewards app: Find providers and HCA Healthcare locations Check costs for care Get notifications with benefits news and reminders Store your ID cards Go to HCArewards.app for instructions. Career Opportunities New leadership opportunities are posted regularly for internal applicants. Internal Candidates: InternalCareers.HCAhealthcare.com Know someone who is perfect for HCA Healthcare? Ask them to go to Careers.HCAhealthcare.com and enter your name in the field for “were referred to this job by an employee.” Did you know? HCA Healthcare operates 254 urgent care centers (as of June 30, 2022).