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Going Above and Beyond

Rachel Fivis,  RN, CN III, H1 Patient Safety Star Award Winner

Rachel Fivis, RN and H1 Unit Educator, made a discerning assessment regarding a medication rolled out hospital-wide in early 2022.  While assisting a primary RN with a hypotensive patient who had received Exparel, a pain management medication, she noticed that the patient had received Cepacol, a throat lozenge containing a local anesthetic containing benzocaine.  Upon further review, one of the contraindications of Exparel was to avoid local anesthetics such as lidocaine and benzocaine for 96 hours after administration of Exparel. 

Rachel brought this to the attention of the pharmacy and the unit Clinical Nurse Specialist, who reached out to the manufacturer.  Her inquisitiveness and attention to detail brought about the formation of a multi-disciplinary task force to further review the medication, and the implementation of other safety measures, including a Best Practice Alert (BPA).   

Thank you, Rachel, for advocating for patient safety and exceptional patient care.  

Submitted by:  Maribeth Cambridge, RN, MS, CCRN, Caritas Coach®

Patient Care Manager H1 ENT/Plastic Surgery/Breast Oncology/Pain

Rachel Fivis

Casey Schade

Rapid Rituximab:  An Inpatient Pilot Project to Increase Education and Use Among Oncology Nurses

Casey Schade is the Assistant Care Manager for E3, the Inpatient Hematology/Oncology unit. She noticed the lack of clinician awareness of the appropriate Rituximab infusion order set and nursing education on administration guidelines, which led to the underuse of Rapid Rituximab Infusion Administration (RRIA).

A quality improvement pilot project was developed to stimulate ordering RRIA, increase nursing knowledge, optimize inpatient chemotherapy admission and discharge schedules, and decrease nursing workload.

Casey's article Rapid Rituximab: An Inpatient Pilot Project to Increase Education and Use Among Oncology Nurses was accepted and published in the Clinical Journal of Oncology Nursing.

Rapid Rituximab: An Inpatient Pilot Project to Increase Education and Use Among Oncology Nurses

Casey Schade, Rapid Rituximab, Administration Guidelines, Quality Improvement, Nursing Education, CJON 2022, 26(4), 433-437. DOI: 10.1188/22.CJON.433-437


We're so proud of you, Casey! Congratulations!

Ambulatory Nursing

Centralized New Hire Onboarding for Registered Nurses and Medical Assistants

Ambulatory Nursing implemented an improvement project to reduce 1-year turnover of new hires in ambulatory care by centralizing new hire onboarding for registered nurses and medical assistants.  In December 2022, the Ambulatory Onboarding Program celebrated its 28th cohort.  

The successful outcomes and key takeaways of this project were showcased in the poster presentation “Redesigning Onboarding to Improve Workforce Retention in Ambulatory Care,” accepted to the 2022 Health Care Con Conference (conference rescheduled to 2023).

A primary goal of the program was to utilize a centralized onboarding to improve staff retention and job satisfaction by focusing on role clarity, peer support, and leadership check-ins. Appropriate staffing is a hallmark of a healthy work environment, with the literature showing that the loss of an RN or MA in the form of turnover contributes to decreased engagement, increased organizational cost, and decreased patient satisfaction.

Since the implementation of the Ambulatory Care Onboarding Program in 2020, ambulatory care areas have seen a 18.1% drop in overall turnover among Registered Nurses and Medical Assistants.

Submitted by:  Sierra Kane, MSN, RN, CNL, AMB-BC, DNC, 

Director of Ambulatory Nursing – Nursing Administration

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