SE9 The organization supports nurses’ participation in community healthcare outreach.
Provide one example, with supporting evidence, of organizational support for clinical nurse involvement in community healthcare outreach.
AND
Provide one example, with supporting evidence, of organizational support for nurse leader involvement in community healthcare outreach.
Example 1 – Clinical Nurse Involvement in Community Healthcare Outreach
BACKGROUND AND PURPOSE
The mission of Baptist Health South Florida (BHSF) is to improve the health and well-being of individuals, and to promote the sanctity and preservation of life, in the communities it serves. As a not-for-profit organization, community involvement is a key strategic goal in the implementation of this mission and is considered one of the pillars for success. Towards this end, Homestead Hospital’s leadership has consistently worked to ensure organizational support for the delivery of community outreach initiatives outside the hospital walls. Homestead Hospital nurses and leaders work in partnership with the community to provide culturally-sensitive care in order to meet the needs of its culturally-diverse target population. This thrust was articulated in the 2013 Nursing Strategic Goals and reflected in the Professional Practice Model under “Collaboration”. The efforts have been focused on the provision of staff resources for community health fairs and screenings to provide health education, as well blood sugar and blood pressure testing along with referrals to health resources within the community for those found to be at risk.
METHODS AND APPROACH
Organizational Support
To increase community involvement, Homestead Hospital’s nursing leadership has set the expectation that nurses who want to exceed expectations in professional accountability (part of the nursing evaluation), the nurse must participate in a community outreach program. These events include health fairs and participation in medical teams for community sporting events or medical missions. BHSF and Homestead Hospital provides support through a variety of ways:
- Staff time – Leaders offer staff support for community involvement by providing flexibility with requests for time off. (SE9 01Time Off Request)
- Educational materials and supplies – Through collaboration with the corporate Community Health department, nurses who participate or organize health fairs can obtain free literature, testing supplies and ancillary staff support for health screenings. (SE9 02 BHSF 502 Community Outreach Program Pro-Active Charity)
- Internal/external event promotion and volunteer recruitment – Corporate Community Relations and Marketing departments assist in promoting the events throughout the system and recruiting for volunteers for BHSF sponsored community healthcare outreach programs. These departments send information for volunteer opportunities throughout the year through emails, flyers and social networking sites.
- Recognition for participation – Through the Volunteering Indicates Professionalism (VIP) policy, nurses and employees who give their time for volunteer service are formally recognized for their community involvement. VIP hours are honored when an employee volunteers time to a community or hospital sponsored event as verified by their manager. Employees complete and submit the VIP Form for each event and the hours volunteered to the Magnet Designation department. The hours are tracked and annual recognition is extended to the volunteers depending on the total number of VIP hours accumulated during the calendar year. The awards can be in the form of Certificates of Appreciation, letters from respective Vice Presidents, meal vouchers or a VIP/Service Award breakfast.
Community Healthcare Outreach
Example of events that clinical nurses participate in include health fair /screening, walk for a cause, clothing or toy drives, fundraising, or habitat for humanity. Additionally, clinical nurses also volunteer time in school, governmental, specialty and volunteer organizations. These activities are captured in their individual professional profile in StepOne, an online RN demographic database. (SE9 03 StepOne Screenshot and Sample Report)
An Exemplar of a Clinical Nurse’s Medical Mission in Haiti
On May 15th, 2014 a group of employees from Baptist Health South Florida embarked on a medical mission to Port-au-Prince, Haiti. Clinical Nurse Cielo Chavez, RN was able to join the team of people from all departments all across the BHSF facilities. She worked with them for a good cause, helping the people of Haiti in need of surgery. BHSF took care of preparations for the trip (vaccinations and travel arrangements). (SE9 04 Travel Information Memo) Chavez’ department also paid for the day she left for the mission in order to complete her worked hours for the week. (SE9 05 Chavez’ Time Card Screenshot and BHSF-HR 6800 Policy)
Volunteering has always been one of the extracurricular activities Chavez enjoyed participating in. And thanks to the support of her leaders in the Surgical Services department at Homestead Hospital, she was able to use her skills as an intensive and post-anesthesia care nurse to help the people in Haiti. The team arrived to Haiti on May 15th, 2014 in the afternoon and headed over to “Double Harvest”, a place where a small clinic was located and this was where all the surgical teams around the U.S. who volunteered, stayed to provide their services. Upon arrival at Double Harvest, the entire surgical team had to help unload the bus with all the food, medications and instruments that were brought for the mission. After everything was unloaded and the equipment was set up in the clinic, the surgeries started. Even though she had originally been assigned to work night shift in the recovery room, she was able to help the Certified Nurse Anesthetists (CRNA) in the operating room (OR) by titrating drips, positioning patients and anything else that was needed. At night her assignment consisted of recovering the post-operative patients along with taking care of those patients staying overnight. Throughout the night, she fed patients; administered antibiotics and routine medications; and monitored for any change in status. Patients spent the night in this 8-bed unit with family members accompanying them throughout the night. The morning after surgery around 5, the team prepared a basic breakfast for the patients and their families. Before day shift came, the patients had already been medicated, had breakfast and took their showers. They would be ready to be discharged home by the incoming shift.
The population of Haiti consists of a high percentage of people with no access to primary care. Unfortunately due to lack of resources and the monetary constraints of this country, adequate or basic healthcare is not provided to their citizens. The kind of patients that would come through the doors of Double Harvest, were patients that were acutely ill. They could be walking around with blood pressures of 250/190 mmHg, fevers of 104 F and open infected wounds for weeks or even months waiting for the next team of healthcare volunteers to arrive and get examined. The team consisted of an extraordinary group of people from all across BHSF - general surgeons, obstetrician/gynecologists, surgical assistants, surgical technicians, OR nurses, preoperative nurses, post-anesthesia care nurses, critical care nurses, 2 local physicians, CRNAs, and ancillary support staff. There were 2 ORs (1 room for simple cases done under local anesthesia, and the other for more complicated cases) 1 preoperative /triage area, and one recovery room. The team performed a total of 59 procedures in 3 days. They performed a variety of cases during this trip, ranging from simple scar removals, hernia repairs, total abdominal hysterectomies, colostomy care, to taking care of a critically ill, septic patient. At this point, the recovery room was used as an emergency room/critical care unit. The team took care of pediatric and elderly patients. They had limited resources, but as a team they worked together to provide the best care possible. For example, they lost power once during a night surgery. They only had 2 monitors and had to share them with all the post-operative patients. The nurses needed to use their skills and knowledge to monitor patients to ensure they would recover safely.
During this trip, Chavez learned how to treat patients from different cultures in terms of difference in language and the ways they expressed their pain. There were 3 cases that made an impact on her during this trip. First, there was a 10-month old baby with human immune deficiency virus (HIV) who had surgery for an umbilical hernia repair. At this young age, she already had respiratory problems due to HIV. But she made it through the surgery and recovery with a beautiful smile and was discharged home safe and sound. The second one was a patient who underwent a colostomy creation so he could be treated at the main hospital in Port-au-Prince. This patient was very thankful for the surgery performed and care given to him during his 2-day stay in the recovery room. The patient rode on the team’s bus. That was the only way he could get to the city for his treatment at the main hospital in Port-au- Prince. He was dropped off at the main hospital with a Foley catheter in place, a fresh colostomy and a hospital gown. He showed a great deal of gratitude towards the whole surgical team. The third patient was a great success story. This patient came in critically ill. He had been walking around with an infection on his left arm for weeks. He was septic with altered mental status from the generalized infection. The team performed a fasciotomy to the left upper extremity, extensive wound care, to be followed by a lengthy treatment of high dose broad-spectrum antibiotics, fluid resuscitation and close monitoring day and night in the recovery room. The team left him as an inpatient in Double Harvest with one of the local doctors taking care of him. He was eventually discharged from Double Harvest and was on the road to full recovery. Chavez learned that it took team work, experience, knowledge and, most of all, the willingness to help another human being to make a difference in this world. She felt proud belonging to an organization that cared enough to help others and supported clinical nurses in reaching out to both the local and global community.
OR Technician and Nursing Student Nancy Thelusma also embarked on this trip to Haiti. She has gone on this trip 2-3 times per year since the Haiti earthquake in 2010. Thelusma was originally from Haiti so her proficiency with Creole was a welcome benefit to the team. She continued her biannual trips to Haiti even though she worked part-time and attended nursing school full time (graduating in December 2014). She was able to do this because of the schedule flexibility that her nursing leaders had afforded her. As a nursing student, she was able to assist the team in a more expanded role (under the direction of an RN). She helped in the preoperative and recovery phases, and completed tasks like starting and discontinuing intravenous lines; giving medications; completing wound checks; and providing discharge instructions.
PARTICIPANTS
Name/Credentials |
Title |
Department |
Role in the Team |
Cielo Chavez, RN |
Proficient Clinical Nurse |
Surgical Services |
Volunteered as recovery room nurse in Haiti |
Nancy Thelusma |
OR Technician Assistant |
Surgical Services |
Volunteered in Haiti; transported patients, provided translation services and assisted the nurses |
Wanda Vargas-Rosado, BSN, RN, CNOR |
Patient Care Manager |
Surgical Services |
Provided support in volunteering activities |
Carmen Bouchard, MSN, RN, CNOR |
Director |
Surgical Services |
Provided support in volunteering activities |
|
Clinical Nurses |
Various departments |
Volunteered in various community outreach activities |
|
Nursing, Homestead Hospital and BHSF leaders |
Various departments |
Encouraged and supported clinical nurses and staff to give back |
OUTCOMES
Due to organizational support for nurses’ (including clinical nurses) involvement in community healthcare outreach, the nursing service department has increased RN participation in FY 2013 by 8% (goal was 5%) with 264 events attended.
Summary Attachments/Hyperlinks/Evidences
SE9 01Time Off Request
SE9 02 BHSF 502 Community Outreach Program Pro-Active Charity
SE9 03 StepOne Screenshot and Sample Report
SE9 04 Travel Information Memo
SE9 05 Chavez’ Time Card Screenshot and BHSF-HR 6800 Policy
Example 2 – Nurse Leader Involvement in Community Healthcare Outreach
BACKGROUND & PURPOSE
Hand-in-hand with clinical nurses, Homestead Hospital nurse leaders are also involved in community healthcare outreach in order to realize the organizational mission as described above. As a community hospital, giving back to the community is a goal that nurse leaders promote among themselves and model for the staff.
METHODS AND APPROACH
Organizational Support
To increase community involvement, Homestead Hospital’s leadership has set an expectation for all leaders to participate in at least 2 BHSF approved community outreach programs. (SE9 06 CNO Email to Nurse Leaders). These events include health fairs and participation in medical teams for community sporting events. BHSF and Homestead Hospital provides support through a variety of ways:
- Staff time – Leaders offer support for community involvement by providing flexibility with requests for time off.
- Educational materials and supplies – Through collaboration with the corporate Community Health department, nurse leaders who participate or organize health fairs can obtain free literature, testing supplies and ancillary staff support for health screenings.
- Internal/external event promotion and volunteer recruitment – Corporate Community Relations and Marketing departments assist in promoting the events throughout the system and recruiting for volunteers for BHSF sponsored community healthcare outreach programs. These departments send information for volunteer opportunities throughout the year through emails, flyers and social networking sites.
- Recognition for participation – Through the Volunteering Indicates Professionalism (VIP) policy, nurses including nurse leaders and employees who give their time for volunteer service are formally recognized for their community involvement. VIP hours are honored when an employee volunteers time to a community or hospital sponsored event as verified by their manager. Employees complete and submit the VIP Form for each event and the hours volunteered to the Magnet Designation department. The hours are tracked and annual recognition is extended to the volunteers depending on the total number of VIP hours accumulated during the calendar year. The awards can be in the form of Certificates of Appreciation, letters from respective Vice Presidents, meal vouchers or VIP/Service Award breakfast. (SE9 07 HH-400-6600-011 Volunteer and Community Service Recognition Program Policy & VIP Form) Homestead Hospital leadership also extends monetary recognition to nurse leaders’ efforts in the community through the annual performance evaluation process. Community involvement can be selected as one of the goals in the Leadership Evaluation Management (LEM) which could account for 10%-20% of the total LEM score. (SE9 08 Sample LEM Annual Evaluation with Community Involvement highlighted)
Community Healthcare Outreach
Events that nurse leaders participate in include:
Event |
Service |
|
|
Screenings/Education/Referrals |
Medical Team |
Manna Center, Good News Care Center Diabetes Support Group |
X |
|
Homestead Hospital Free Community Health Fair |
X |
|
Baptist Church Health Screening Fair (Grace Community Baptist Church, Homestead) |
X |
|
Diabetes Education Health Fair( First Methodist Church of Florida City, Homestead) |
X |
|
Miami Dade County Fair First Aid Volunteer |
X |
|
Richmond Heights Community Outreach for Breast Cancer Screenings |
X |
|
Chinese New Year Festival, Miami-Dade College, Kendall |
X |
|
First Aid Volunteer at City of Homestead Centennial Celebration |
|
X |
First Aid Station for INC Marathon |
|
X |
Health Assessments & Physicals for Special Olympics |
|
X |
Medical Missions (Aruba, Jamaica, Philippines) |
|
X |
Chinese New Year Festival
A good example of a community healthcare outreach program that Homestead Hospital nursing leaders have been involved in over the years is the annual health screening at the Chinese New Year Festival. Nurse Leaders work closely with core leaders of BHSF Chapter #222 of the Academy of Medical-Surgical Nurses (AMSN), a national professional nursing specialty organization, with whom most of them are members of. Months before the event is scheduled, the AMSN Chapter president sends out e-mails soliciting volunteers to staff the events. (SE9 09 Email from AMSN Chapter President) The e-mails outline the name, date and time of event as well as shift information, sign up information, directions, tasks and services to be provided (e.g. educational, screening, medical). With the support of BHSF and Homestead Hospital, nurse leaders are able to sign-up, request time-off and plan for the health screening.
PARTICIPANTS
Nurse Leader Involvement
Homestead Hospital nurse leaders involved in the Chinese New Year Festival were:
Name/ Credentials |
Years RN Experience |
Title |
Department |
Maureen Allen, MSHA, BSN, RN, CMSRN |
21 |
Patient Care Manager |
MS4 |
Flor Amaya. BSN, RN, CMSRN |
10 |
Patient Care Supervisor |
MS4 |
Anita Carrillo, MSN, BSN, RN, CMSRN |
10 |
Patient Care Supervisor |
MS4 |
Lois Johnson, MBA, BSN, RN, CMSRN |
38 |
Patient Care Supervisor |
MS4 |
Eva Joseph, BSN, RN, CMSRN |
35 |
Patient Care Supervisor |
MS4 |
Alma Liu, BSN, RN, CMSRN |
18 |
Patient Care Supervisor |
MS5 |
Charmaine Richards, BSN, RN, CMSRN |
23 |
Patient Care Supervisor |
MS4 |
OUTCOMES
In an effort to better track community outcomes; improve the delivery of outreach services; and close the gap in the continuum of care that takes a patient from referral to seeking care, nurse leaders implemented a newly developed, simple data collection tool and patient follow-up mechanism for the 2014 health fair. This information allowed them in determining the reach of HH community involvement initiatives by collecting the following indicators:
- number of contacts made,
- number of screenings done
- number of referrals made based on the screenings
Some of the topics included in the education were the importance of annual check-ups, healthy eating and exercise. The total number of contacts was tracked by the use of “clickers” to count the number of persons each nurse gave health education information or materials to. In order to assess the demand for specific educational materials, RN volunteers tracked and compared the number of educational materials taken to the event and the number remaining at the end. As screenings were done, they tracked the number and type of screenings performed and the number of normal and abnormal results seen. They counseled individuals with abnormal results to see their primary care physician or to visit their health clinic as soon as possible.
At its most recent outreach event, the Chinese New Year Festival held on February 16, 2014 at the Miami-Dade College, Kendall campus, a team of 12 nurses implemented the newly developed data collection procedure. As such, the following data were obtained: (SE9 10 Fair Log)
Exhibit SE9: Event Data – 2014 Chinese New Year Festival
Indicator |
Event data |
Number of contacts |
166 |
Number of screenings done |
Blood sugar: 118 Normal: 98 Abnormal: 20 |
Number of referrals made |
11 |
Summary Attachments/Hyperlinks/Evidences
SE9 06 CNO Email to Nurse Leaders
SE9 07 HH-400-6600-011 Volunteer and Community Service Recognition Program Policy & VIP Form
SE9 08 Sample LEM Annual Evaluation with Community Involvement highlighted
SE9 09 Email from AMSN Chapter President
SE9 10 Fair Log
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