2016 January

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President’s Message

Judy Philbrook

Happy New Year … and Happy Anniversary to CANNP! CANNP was founded 25 years ago!!

The original mission was to:

  1. establish an organization to facilitate professional development, education and research for the neonatal nurse practitioner
  2. to provide a communication network for exchange of ideas regarding practice, education and the professional role of the neonatal nurse practitioners; and
  3. to participate in the legislative activities regarding nurse practitioner scope of practice specifically in the neonatal care area.

We continue to strive to meet these goals to improve both ourselves and our care. We have come a long way! 

A lot has changed in 25 years!

  • First, professionally with consensus models for APRN regulation (LACE), workforce surveys, mandatory certification and specified maintenance, increased continuing education requirements…
  • Secondly, a lot has changed in the management of our precious babies. Ventilators and respiratory management techniques, which include highfrequency and NAVA ventilation, surfactant, more rapid weaning leading to less ventilator days, bubble CPAP… We have studied nutrition and have learned how to improve growth. We have implemented new strategies, such as body cooling for HIE, and Laser therapy for ROP. We have looked at old strategies (PDA ligation) and have reshaped care.
  • Lastly, communication, random safety audits and new NICU designs have been hot topics. 

CANNP offers an annual conference to address changes and “new” things. It is a great opportunity to educate ourselves, but also to see what our neighbors are doing and to network.

We have offered our first web-based contact hour offering this year for members only. A lecture from the 2015 conference on nutrition is available for viewing and credit through Sept 2016. Another offering on x-ray interpretation is underway.

Please help us help you—let us know what is helpful, contribute to our newsletter, or prepare a presentation for the website!

Lastly, tell your colleagues about CANNP and encourage them to join!

See you at the conference! 

Conference Highlights 2016

The 2016 conference will be held on April 21 & 22.

The conference is titled “Shades of Blue: Collaboration in Neonatal Care Across the Carolinas.” Please see the event page for the agenda.

Members of the conference planning committee are:

  • Cynthia Baker NNP
  • Stephanie Blake NNP
  • Amy Jnah DNP, NNP
  • Sherry LeBlanc NNP
  • Felicia Soza NNP

The committee has worked hard to ensure a wonderful conference. Join us in Durham for a great conference, a chance to network with colleagues from North and South Carolina, continuing education credits and perhaps some shopping or sight seeing.

Brochures have been mailed. If you have not received one, please email Kathy Connelly. 

Peer Recognition

It is time for the annual CANNP Peer Recognition Award. The award nomination forms can be found on-line at the CANNP website: cannp.org. Please consider nominating a well deserving colleague for this meaningful award. Can you think of a better way to say “Well done, Great Job, I’m glad you are on our team, I admire you, you are my role model or thanks for being a great mentor”? Recipients of this award have been pleased that colleagues took the time to recognize them for their contribution to the team. All too often we hear complaints or we are the ones voicing complaints about the lack of recognition for our commitment to our profession and our length of service to an organization. Here is your chance to change this and honor a member of your team. Please consider each team member, their dedication to your unit and infants, efforts to improve or maintain personal education and education for other team members, involvement in unit projects or committees and personal commitment to the continued development of the advanced practice role. Applications can be found on the website and should be mailed to Kathy Connelly 6104 Wolverhampton Dr. Raleigh, NC 27603 and must be postmarked by April 1, 2016. 

The award will be announced and presented during the business meeting at the annual conference on April 21st. 

CANNP Scholarship Award

CANNP Scholarship The purpose of this award is to recognize an individual who has returned to school to enhance their role as an NNP and provide them with a scholarship award for financial assistance. CANNP is seeking applications from NNPs functioning within our organization who are currently in an educational program seeking an undergraduate or graduate degree. The award recipient will receive a $1000.00 monetary award. The award presentation will be made on April 21st at the business meeting held during the conference.

CANNP Scholarship and Grant Application Applications and additional information can be found on the CANNP website. Completed applications should be mailed with current curriculum vitae to: Kathy Connelly 6104 Wolverhampton Dr. Raleigh, NC 27603. Applications must be postmarked by April 1, 2016.

CANNP Grant Application

The purpose of this award is to assist CANNP members who are involved in clinical research with funding for their project. The grant is for $1000.00. NNPs must be CANNP members for at least two years. Applications are due by May of each year and award notification takes place by August 1st. The CANNP Grant Application can also be found at the CANNP website. Completed applications can be mailed to Kathy Connelly 6104 Wolverhampton Dr. Raleigh, NC 27603 . For questions about either of these awards, please check the web site for additional information and/or email Kathy Connelly at kathy@deadlypenguin.com. 

Election Results:

Elections were held for the Board of Directors in the Fall of 2015.

Election results are as follows:

  • President: Judy Philbrook
  • Vice President: Kathy Connelly
  • Secretary:  Amy Jnah 
  • Treasurer:  Sharon Rush
  • Member at Large: Christine Rowland

CANNP wishes to thank the outgoing Board Members for their dedication, time and service. The organization has continued to grow and develop under their leadership. Congratulations to the new Board members! Thank you for taking on the daunting task of running and growing our organization! Your ideas and energy are vital to maintain and expand our organization and its impact on advanced practice in the Carolinas.

Dr. Amy Jnah is a board certified neonatal nurse practitioner, professor, researcher, Army wife and mother of two. She is the director for the neonatal nurse practitioner concentration (MSN) with East Carolina University. Dr. Jnah has published articles in several peer reviewed nursing journals, several textbook chapters (to be released in 2016) and is a nurse researcher within the clinical and academic setting. Her academic research trajectory includes mentoring and its implications for the neonatal nurse practitioner workforce. Dr. Jnah's clinical research trajectory include non-invasive screening mechanisms for premature neonates, psychomotor skills competency, and simulation -based training. In her "spare" time, she enjoys triathlons, tennis and vacations to the beach with her family!

Dr. Christine Rowland is also a board certified neonatal nurse practitioner. She currently practices full-time in the NICU at Levine Children’s Hospital at Carolinas Medical Center in Charlotte NC. She also enjoys working PRN at Catawba Valley Medical Center in Hickory. She received her BSN in 2006 from the University of Akron, her MSN in 2011 and DNP in 2015, both from East Carolina University. Her areas of clinical interest and scholarship include delivery room management, advanced neonatal procedures, developmental care, necrotizing enterocolitis prevention, quality improvement, and application for best practices. She is a proud member of American Nurses Association, NC Nurses Association, National Association of Neonatal Nurse Practitioners, and CANNP. She married her husband Steve this past summer in beautiful Charleston, SC, and in her free time she enjoys running, gardening, reading, traveling, and volunteering for the March of Dimes. 

Secretary’s Report: Kathy Connelly Minutes from the last annual business meeting will be displayed outside of the conference room at the 2016 Conference. Treasurer’s Report: The CANNP balance is currently: $25,154.77 Member-at-Large: Sharon Rush CANNP currently has 56 members. It is time to renew your membership. A membership application form is enclosed in this newsletter or you may obtain one from our website. Applications must be received by or at the annual conference. Applications will be considered late after the conference and a $5.00 late fee will be assessed to members who have not renewed their membership by this deadline. Please encourage all members of your team to join or rejoin and be active in this worthwhile organization. The address for renewals and correspondence is: CANNP C/o Judy Philbrook 6474 Summerchase Drive Fayetteville, NC 28311

Educational Feature:

Multidisciplinary Rounding (MDR) Nicole (Nikki) Barrett MSN, NNP-BC Volume 6 Issue 1 Page 5

The event was facilitated by a performance improvement advisor. First, the team identified shared goals for the MDR model that included improving quality and satisfaction as defined by the family, improving continuity of care, and reducing potentially harmful errors. The team spent the entire day creating a model that included geographic bed assignments, a plan for involving and communicating with patients, assigned roles that gave all team members voice and an opportunity to collaborate, a nurse recap of the daily plan of care, and “real-time” electronic order entry. Based on parental feedback regarding privacy concerns, the decision was made to hold rounds at a table at the end of the hallway rather than at each bedside. The daily MDR team, which includes the doctor, nurse, nurse practitioner, nutritionist, pharmacist, respiratory therapist, case manager, and parent(s), started a trial of their newly designed rounding model in October 2014. The Mission Hospital NICU team recently transformed their Multidisciplinary Rounding (MDR) Experience. The purpose of this project was to implement a coordinated, streamlined, family-centered, quality rounding experience for every baby every day. When the MDR committee started their work in early 2014, process and care varied greatly from provider to provider and the overall NICU team’s daily workflows were disconnected, fragmented, and often redundant. Great opportunities existed, particularly surrounding consistency and communication. After several unsuccessful attempts at implementing a new MDR model during the first half of 2014 the NICU team decided to hold a one-day kaizen event in quest of an innovative MDR model for trial. The 20 kaizen attendees included: 

  • NICU RN’s
  • Neonatal Nurse Practitioner’s
  • Neonatologists
  • NICU Respiratory Therapists
  • Mission Physician
  • MDR Champion
  • NICU Case Manager
  • NICU Pharmacist
  • NICU Educator
  • NICU Leadership
  • NICU Family Member

The event was facilitated by a performance improvement advisor. First, the team identified shared goals for the MDR model that included improving quality and satisfaction as defined by the family, improving continuity of care, and reducing potentially harmful errors. The team spent the entire day creating a model that included geographic bed assignments, a plan for involving and communicating with patients, assigned roles that gave all team members voice and an opportunity to collaborate, a nurse recap of the daily plan of care, and “real-time” electronic order entry. Based on parental feedback regarding privacy concerns, the decision was made to hold rounds at a table at the end of the hallway rather than at each bedside. The daily MDR team, which includes the doctor, nurse, nurse practitioner, nutritionist, pharmacist, respiratory therapist, case manager, and parent(s), started a trial of their newly designed rounding model in October 2014. 

While the team continues to meet and make further refinements through PDSA cycles, the process has been largely successful. Most recent enhancements include an MDR invitation for family members and modification of geographic location of patients, concentrating short stay patients in one area and more acute patients in another area. Measurable improvements have been noted. Parents often participate in rounds and patient satisfaction scores have significantly improved, particularly regarding “Doctor’s Communication/Keeping Patient Informed” and “Overall quality of care”, “Overall Quality of Care”, and “Overall Level of Safety”. When asked what was outstanding about the NICU experience, one parent said, “The daily round tables that the doctors and the team do for each baby. I think that’s outstanding… and the fact that the parents can attend that and be a part of it.” The positive changes were not only noticed by the families, but staff too. A survey of the NICU team revealed that 89% of providers and 97% of bedside nurses agreed that MDR has positively impacted patient care. This project was successful and successfully hardwired because it was created and owned by a multidisciplinary team, family feedback was a top priority, and the NICU team debriefed weekly through several PDSA cycles. Feedback from multiple parent and staff surveys continue to drive PDSA trials. 

Practice Site Updates

Cape Fear Valley: It’s been a fairly quiet 6 months here at the Valley, however we have just recently welcomed the newest little member to the Coggin family. Congratulations to Dr. Kristin Coggin and husband Myers on the birth of their 3rd child Madelyn “Elliot” Coggin. She made her big entrance on the morning of January 7th, a few weeks early, saving her mother from those last few call shifts before a much needed leave. Big sister Merritt and brother Sullivan are hopefully adjusting well. Another note of congratulations, to Wendy Brock NNP-BC DNP on her poster presentation on “Improving Interdisciplinary Communication in the NICU” at the Vermont Oxford Meeting in Chicago on October 3-4. She has been very busy winding down the completion of her DNP program in December. Again congratulations Wendy and thank you for all your hard work.

WakeMed: Well, where to begin! This has been a busy year for WakeMed. We opened up a new birthing center, WakeMed North, in May and although it has had many growing pains, they have become the place to deliver! The rooms are the size of a small apartment (well maybe not that big) but very spacious. The Special Care Nursery has 6 private rooms and of course 24/7 coverage by our NNP’s. Our Raleigh location is getting ready to open new Labor & Delivery rooms, OR and Neonatal resuscitation room this month. They are just as beautiful as North! Our Cary location has been so busy that we had to hire a part time PNP to help see all the newborns! On a more personal note, Desi Newberry NNP gave birth to a beautiful baby boy, William, in August. Tracey Robertson NNP married Victor Bell in October. Both continue to be professors at ECU’s NNP program in which Amy Jnah is the director. Amy also joined the CANNP Board as the new secretary starting this month.  Amy will be a wonderful addition to the board. She has also been very busy working with the 2016 CANNP conference committee. Many thanks to Amy for that also. Dr. Ross Vaughan also retired this summer. Ross was the oldest practicing Neonatologist in NC at the time of his retirement. We continue to grow our Neonatology family! This month, we will add a new Neonatologist, Claudia Cadet MD, who joins us from Rex Hospital. We are excited to have her with us, but sad for Rex. Ginger Rhodes-Ryan NNP has been extremely busy in her role as research coordinator for the NICU. We have added so many new studies; we are having a hard time keeping up with them. Good thing Ginger can keep them all straight! If you are ever in the Raleigh area, please feel free to come by for a tour! We love to show off our new renovations!

Womack Army Medical Center: It has been a busy summer and fall for our practice. We officially dropped down to keeping 28 weeks gestation infants in our NICU! Our ongoing collaboration with ECU and placing student NNPs continues. We bid a fond farewell to Paula Roach, MSN, NNP-BC as she joined the new practice at Southeastern Regional Medical Center that is expanding their Special Care Nursery to care for more preterm infants. Also moving on in her Air Force military career, LTC. Sherreen Batts, one of our Neonatologists is now working at Portsmouth Naval Center in their NICU. We welcomed MAJ Eleana Beadle from Hawaii as our new Neonatologist replacing Dr. Batts. Dr. AJ Grein has spread his business wings and became one of the partners (besides continuing to be our Medical Director) in an established B&B known as the Applewood Manor in Asheville, NC. Liz Lawrence, NNP-BC became a grandmother for the second time in July. Grandson Maximilian joined his big sister Lana and his family in Charlotte. Liz also became a first time owner/breeder/handler of a National Champion Arabian Yearling Colt, Sport Horse in Hand– Psylent Rockstar at Sport Horse Nationals last fall in Raleigh. She also garnered a National Top Ten placing in the 2 year old Filly Sport Horse in Hand with Sweet Psylence, Psylent Rockstar’s big sister! Very exciting times for Legacy Farms. We welcome Jenny Porter, MSN, NNPBC to our Neonatology team! Jenny was one of our staff nurses that actually did some of her clinical time with us as she was going through her NNP classes. She has been working at Cape Fear Valley Medical Center since completing school and we are excited to be welcoming her back. 

Editor's Comments

Remember: It is time to renew membership. This form is attached or may be downloaded from the CANNP website. We would like to encourage you to consider nominating a member of your group for the annual peer award. Also note information about the scholarship award. If you are a member in good standing and are working on a degree, please consider applying for this award. The Research Grant Application Form is also discussed. Please go to the web site and take a look at this form. If you are considering or are currently involved in a research project, please consider applying for this monetary award. We would like to again encourage all members to consider writing an educational feature for this newsletter. Sharing information and practice initiatives is rewarding and important to our membership. The newsletter is an important communication tool. This tool however may be limited if only a few NNP’s contribute to it. CANNP needs you, your ideas, experiences and energy to continue the growth we have experienced over the past several years. Please email comments, suggestions, articles or practice site up-dates to : Christine Rowland at chrissyj6482@yahoo.com