Office of Nursing Services (ONS)
Clinical Practice Program (CPP)
The Clinical Practice Program (CPP) was developed by the Office of Nursing Services (ONS) to support nursing practice at the point of care. The program currently consists of ten Field Advisory Committees (FACs) in the following specialties: Cardiovascular, Geriatrics and Extended Care, Mental Health, Metabolic Syndrome/Diabetes, Oncology, Perioperative, Polytrauma & Rehabilitation, Emergency Department, Pain Management, and ICU. The FACs develop policies in coordination with other VHA program offices and to disseminate communication to the field.
The Clinical Nurse Advisors serve as Subject Matter Experts to the Chief Nursing Officer and represent ONS on a variety of national committees and work groups. In addition, they are responsible for leading their ONS FAC in the development, promotion, and diffusion of best practices promoting enhanced Veteran access.
Each FAC is comprised of field-based nurses, representing all nursing roles and levels of education. The Clinical Nurse Advisors guide their FACs in
- Aligning work of assigned patient populations with National Nursing Strategic Goals/Objectives.
- Identifying/developing and/or recommending:
- best practice, clinical practice guidelines, standards of care, and policy guidance
- staff/patient/caregiver training and educational priorities
- products and/or tools for use by nursing staff at the point of care
- research agenda for clinical inquiries
- publications and appropriate mechanisms for dissemination of best practices
- potential oversight functions needed in the field in the area of focus
Clinical Practice Program Manager
Suzanne Thorne-Odem, DNP, APRN, FNP-C serves as the Clinical Practice Program Manager. She has worked at the VA for 30 years. Suzy provides additional support for a variety of projects in the Office of Nursing Services including initiatives related to mental health, homelessness and Advanced Practice Registered Nurses (APRN). She has a passion for forensic nursing and has practiced as a Sexual Assault Nurse Examiner (SANE), as well as, a Medical Examiner Investigator. She also serves as a Nurse Practitioner and has volunteered as a provider in the care of homeless and uninsured patients.
Cardiovascular Clinical Nurse Advisor
Jennifer Ballard-Hernandez, DNP, AG/ACNP-BC, FNP-BC, GNP-BC, CVNP-BC, CCRN, CHFN, AACC, FAHA, FAANP is the Cardiovascular Clinical Nurse Advisor for the Office of Nursing Services. She is field based at the Tibor Rubin VA Medical Center in Long Beach, California where she works as a Cardiology Nurse Practitioner. Her clinical practice focuses on general cardiology and advanced heart failure management. Dr. Ballard-Hernandez completed her Family Nurse Practitioner training at the University of California, Irvine, her Acute Care Nurse Practitioner training at the University of Pennsylvania, and her Doctor of Nursing Practice Degree at the Western University of Health Sciences. Dr. Ballard-Hernandez has published her work in several peer reviewed journals and has lectured nationally for multiple professional organizations on a variety of cardiology topics including heart failure, care transitions, and cardiac stress testing. She currently serves as the a co-investigator of qualitative and quantitative research, examining the application of palliative care in heart failure and pharmacologic research for atrial fibrillation and heart failure. Dr. Ballard-Hernandez serves on several national committees and is currently appointed to the Federal Cardiology Section Leadership Council for the American College of Cardiology.
The Cardiovascular FAC is made up of ten nurses from around the country and includes staff nurses, nurse managers and nurse practitioners. They actively work on many cardiac nursing projects and represent nurses on a variety of national committees.
Community Living Center Clinical Nurse Advisor
Alexandra (Ali) Caley, MN, RN-BC, PHCNS-BC, is a Clinical Nurse Specialist (CNS) working at VA Portland Health Care System (VAPORHSC). She holds two American Nurses Credentialing Center Certifications: Public/Community Health Clinical Nurse Specialist and Gerontological Registered Nurse. She completed her Master’s in Nursing in Advanced Population Health from Washington State University in 2013 and she also earned a Graduate Certificate in Nursing Leadership. Ms. Caley earned her Bachelor of Science in Nursing from the University of Portland in 2006. She has been working for VAPORHCS since 2003 in various roles that include being a student nurse technician for the Community Living Center (CLC), a staff nurse on a medical/oncology unit and home-based primary care, and for the past six years a CNS at the CLC. Her role as CNS in the CLC functions in the three spheres of influence: Veteran, nurse, and system including leading and implementing quality improvement projects and process changes for the unit, facility, and system level. Ms. Caley is Six Sigma Lean Yellow/Bronze Belt certified and is in the process of obtaining her Green/Black belt certification at VAPORHCS. She also plans to start her Doctor of Nursing Practice Degree in Executive Leadership in January 2022.
The Community Living Center Field Advisory Committee has 10 members, current workgroups/projects include: Catheter Evaluation Protocol. The committee is available to assist the field with questions and education.
Emergency Department Clinical Nurse Advisor
David Pena MSN, MBA, RN, CEN, has 15 years of nursing experience all of which is in Emergency Medicine and is certified in Emergency Nursing by the Emergency Nursing Association. He has been the Emergency Department Manager in Madison, WI since 2013 and has been part of the Emergency Nursing Field Advisory Committee since 2015. Dave currently serves in the United States Army Reserves as a Major in the Emergency Room and was deployed to Afghanistan in Support of Operation Enduring Freedom, where he served in the ER, ICU, OR, Lab, and IT. He most recently came back from 16 months on active duty as the Mobilization Officer for 2 units that were being deployed to various theaters of operations. Dave also works at a local level 3 Trauma Center in the ER as a staff nurse on a per diem basis. Prior to joining the VA Mr. Pena worked in the private sector at a level 3 Trauma Center, Stroke Center, and Chest Pain Center in Northeastern Wisconsin as an ER RN and then as a Medical/Surgical Nurse Supervisor. Mr. Pena earned his Bachelor’s Degree in Nursing from the University of Wisconsin-Oshkosh, and his Master of Science in Nursing and Master of Business Administration with emphasis on Healthcare Administration from The University of Phoenix, AZ. Dave has a wife and three children (ages 3, 6, and 7).
The Emergency Department Field Advisory Committee (FAC) consists of eight nurses ranging from staff nurses to nurse managers.
Geriatrics and Extended Care Clinical Nurse Advisor
Maureen Haske-Palomino, DNP, MSN, GNP-BC, is a Gerontologic Nurse Practitioner who is a co-developer and leader of a nurse run inpatient geriatric consult service at the Madison VA. Maureen’s practice focuses on prevention of functional decline and hospital-acquired complications in hospitalized older veterans. Maureen has held national certification as a Gerontologic Nurse Practitioner for over 20 years. She completed her undergraduate nursing degree at Marquette University, Master of Science and NP degree at UCLA, and her Doctorate of Nursing Practice degree at Duke University. Maureen received the 2019 VISN12 and Madison VA award for Nursing Excellence Registered Nurse in an Advanced Role. She has worked at the Madison VA for 8 years. Prior to joining the VA, Maureen worked for Kaiser Permanente providing geriatric care in nursing facilities, patient’s homes, and outpatient specialty clinics. Maureen also served as the manager for clinical operations at the University of California Irvine School of Nursing where she taught at the undergraduate and graduate level and was responsible for CCNE and Board of Nursing accreditation compliance.
The Geriatrics and Extended Care Field Advisory Committee is made of field based members with expertise in geronotological nursing practicing in a variety of patient care settings. Recently completed projects include: Gerontological Nursing Review Course (available in TMS), GeriPACT Initial Nursing Competency Assessment Document, and Capacity Education Handouts.
ICU/Med-Surg Clinical Nurse Advisor
Russell S. Coggins, RN, MSN is the Clinical Nurse Advisor of the ONS ICU/Med-Surg Field Advisory Committee and has been a member of that group since 2011. He has worked as a Registered Nurse since 1997. The majority of his nursing career has been spent working in various Critical Care Units as a staff nurse. Russ has been with the VA since 2007, a Nurse Manager since 2008 and is currently the Nurse Manager of the Surgical ICU of the Charles George VA Medical Center in Asheville, NC. He earned his BSN from Western Carolina University in Cullowhee, NC, and his MSN from Walden University. He is a member of the VISN 6 IPEC Steering Committee and Chair of the VISN 6 Nurse Manager Academy Planning Committee as well as various facility committees. He is a Veteran, having served in the US Army during Desert Shield and Desert Storm as a M1A1 Armor Crewman, in the Tennessee National Guard as a Cavalry Scout Platoon Leader and in the Army Reserve as an Officer with the Army Nurse Corps.
Mental Health Clinical Nurse Advisor
Elizabeth Czekanski, DNP, MS, RN-BC, NE-BC, VHA-CM joined the VA Pittsburgh Health System in 2006 as a psychiatric nurse manager. Prior to joining the VA, she began her career working for the University of Pittsburgh Medical Center as a staff nurse and as a multi-unit manager of inpatient psychiatry and chemical dependency units contributing to her 17 years as a psychiatric nurse manager. Throughout her nursing career, Dr. Czekanski has worked in various roles including as Director of a residential program for homeless, chemically addicted women and as an independent legal nurse consultant. Since 2008 she has served as Adjunct Faculty at Carlow University in Pittsburgh, teaching psychiatric-mental health nursing. Dr. Czekanski earned her Doctor of Nursing Practice degree from Carlow University and currently holds two ANCC Board Certifications, as a Nurse Executive and Psychiatric Mental Health Nurse, and is certified as a VHA mentor. She is a 2011 graduate of the VA Network Executive Healthcare Leadership Institute and is currently serving as the Office of Nursing Service Mental Health Clinical Nurse Advisor.
The Mental Health Field Advisory Committee completed several projects including a RN Guide for Psycho-educational Groups, a Toolkit for Teaching Diabetes Self-Management, and several fact sheets. The Mental Health FAC provides consultation to behavioral programs throughout the VA system.
Metabolic Syndrome/Diabetes Clinical Nurse Advisor
Sharon A. Watts DNP, FNP-BC, CDE has been a nurse practitioner for 30 years, has her Nursing Doctorate from Case Western Reserve University and is a Certified Diabetes Educator and Family Nurse Practitioner. She is active in diabetes quality improvement research and publishing manuscripts on diabetes. She holds a Black Belt in Lean Six Sigma Quality Improvement. She has been an invited guest speaker for National Diabetes Forums such as American Diabetes Association, American Association of Diabetes Educators and VA/DoD National conferences. Sharon sits on many local and National diabetes related committees. She has been a member of and currently serves as Chair of the Metabolic Syndrome & Diabetes Field Advisory Committee (FAC).
The Metabolic Syndrome/Diabetes Field Advisory Committee has 9 members and current projects/workgroups include: diabetes competencies for both inpatient/outpatient nurses & education modules for nurses.
Oncology Clinical Nurse Advisor
Lori Hoffman Hogg, MS, RN, CNS, AOCN ® is the VHA National Oncology Clinical Advisor for the Office of Nursing Services and Chair of the Oncology Nursing Field Advisory Committee (ONC-FAC). Currently the National Program Manager, Prevention Policy for the VHA National Center for Health Promotion and Disease Prevention- NCP (10P4N) Durham, NC, she has also served as the Cancer Program Director at the Albany Stratton VA Medical Center in Upstate, New York. Lori holds a Master’s of Science Degree in Nursing and Clinical Nurse Specialist in Adult Health. She is an Advanced Oncology Certified Nurse by the ONCC and is a graduate of the VHA Executive Career Field Development Program. Nationally, she has served as planning committee member and faculty for the VHA Cancer Care Collaborative and Co-Director for the VHA Surgical and Specialty Care Collaborative for Medicine. She is a liaison member to the Specialty Care Services ONC-FAC and serves on the VHA National Radiation Oncology Safety Committee and Radiation Palliative Care Task Force. Lori was a charter member of National Center for Ethics in HealthCare Life Sustaining Treatment Advisory Board for the National Goals of Care Conversation Project. She served for six years as an appointed member to the National Academies of Sciences Health and Medicine Division’s National Cancer Policy Forum. She currently serves on the NCI’s Healthy People 2030 Cancer Workgroup and received the NIH National Cancer Institute Director’s Award of Merit in recognition of outstanding leadership and contributions to the development of National Cancer Health Objectives for Healthy People 2030.
The Oncology Field Advisory Committee (ONC-FAC) has 10 expert members who are field-based, geographically diverse and clinically well versed in hematology/oncology and radiation oncology nursing practices for cancer care across the continuum, ensuring evidence based care for this patient population. Project and workgroup outcomes include: Conducting and disseminating oncology research, developing Chemotherapy/Biotherapy Competency Handbook, testing and validation of nursing sensitive indicators with ONS and the Office of Quality and Performance; development of functional statement for the cancer care coordinator role for navigation; oncology skills documentation tools; sample oncology policies and patient education; developing cancer survivorship resources for VHA, participating in lecture series development such as Cancer Care Essentials for the PACT RN Care Managers, development of patient education materials for Veterans located in the Veterans Health Library and co-authoring VHA National Directives.
Pain Management Clinical Nurse Advisor
Debra Hall, PhD, MSN, RN, CCRN-K is the Clinical Nurse Expert for the Critical and Progressive Care Units and the Emergency Department at the Troy Bowling Campus of the VA HealthCare System in Lexington, Kentucky. She has been certified in Adult Critical Care (Knowledge Professional) since 1988. Dr. Hall provides a resource for evidence based clinical nursing practice, program/project development and research and ongoing education. Her professional experience includes Critical Care Staff Development Specialist, Clinical Nurse Researcher, and Director of Nursing Practice Improvement/Research/Education and Director of Educational and Leadership Development before re-joining the Department of Veterans Affairs in 2016. She has published in peer reviewed journals and has presented research and clinical evidence-based practice nationally. Dr. Hall received her PhD in Nursing from the University of Kentucky with a focus on occupational stress, her Master of Science in Nursing from the University of Kentucky with a concentration in Critical Care and Education and her Baccalaureate degree in Nursing at Marshall University. She is the past President of the local Chapter of Sigma Theta Tau and a member of several national nursing organizations. CAPT Hall, NC, USNR, (ret.) served in the Navy Nurse Corps for 20 years in various military treatment facilities, including National Naval Medical Center Portsmouth, Naval Medical Center San Diego, Naval Hospital Pensacola and Naval Hospital Camp Lejeune. She was the Officer in Charge of OHSU Great Lakes, Det Bravo, served as the Officer in Charge of a Medical Readiness Training Exercise in Suriname, South America, and was deployed to the NATO Role 3 Multinational Medical Unit, Kandahar, Afghanistan as a critical care nurse.
The Pain Management Field Advisory Committee is comprised of 9 field-based members with a wide range of experience and expertise in multimodal management of pain in clinical settings. Recently completed projects include Opioid Use at End of Life.
Perioperative Clinical Nurse Advisor
Lisa Warner, RN, MHA, CNOR is the Clinical Nurse Advisor for the Perioperative Field Advisory Committee. Lisa is field based at the Phoenix VA Medical Center in Arizona where she also works half time as a Surgical Quality Nurse. Prior to this role, she served as the nurse manager of the OR, PACU and Same Day Surgery for over 13 years. She serves as a member of the OR Nurse Manager Advisory Board for the National Surgery Office, is a member on the Optimizing Patient Flow & Technology (OPF&T), is a member of the CIS/ARK Advisory Board, is a member of the VISN 18 Sterile Processing Services (SPS) Committee and VISN 18 Surgical Work group.
The Perioperative Field Advisory Committee (FAC) has 11 members. The FAC facilitates monthly conference calls with OR Nursing Leader, Ambulatory Surgery Center Nursing Leader and manages the OR Nurse Leader SharePoint. The FAC is currently involved in or working on the following projects: Working with System Redesign on Surgical Flow Improvement Initiative, working with DoD, the American Pain Society and the American Society of Anesthesiologists to develop post-operative pain guidelines, working on best practice for cleaning the OR, decreasing distractions in the OR, encourage a smoke free environment, examine the RNFA role as an adjunct to resident staffing and developing an educational tool for Vista Intraoperative Nursing Documentation.
Polytrauma Clinical Nurse Advisor
Susan Pejoro, RN, MSN, GNP-BC is the Office of Nursing Services Clinical Nurse Advisor for the Polytrauma Rehabilitation Field Advisory Committee. Ms. Pejoro is a Board Certified Gerontological Nurse Practitioner with over 23 years spinal cord injury nursing expertise currently employed at the Veterans Administration Palo Alto Health Care System as an Inpatient Nurse Practitioner. Prior positions include leadership roles in the Office of National Veterans Sports Programs and Special Events in Washington D.C. as both the Deputy Director and Acting Director during FY2013 addressing and aligning the clinical priority of rehabilitation and adaptive sports for our nations Veterans with disabilities as well as collaborating with Veterans Health Administration leadership to support adaptive sports for its long term health benefits. She is a former Paralyzed Veterans of America (PVA) Consortium for Clinical Practice Guidelines committee member representing ASCIP - Nursing Section from 2011- 2013. Ms. Pejoro was also selected an expert reviewer for the PVA Consortium for Clinical Practice Guidelines: Preservation of Upper Limb Function Following SCI and Sexuality & Reproductive Health. And, she is a current expert reviewer for the Journal of Sexuality and Disability.
The Polytrauma Rehabilitation Field Advisory Committee (PFAC) has 10 members. They represent all aspects of Polytrauma Rehabilitation and the diverse roles that are a crucial component of the Polytrauma System of Care, serving the OEF, OIF, OND (Afghanistan and Iraq) Veterans and their families. Members of the PFAC assisted in drafting components for the Caregiver Legislation, in developing the Spinal Cord Injury content for the Veterans Health Library and provided input for revisions to many handbooks and policies.
Pressure Injury Prevention and Management Clinical Nurse Advisor
Shantia McCoy-Jones, MSN, RN, CRNP, CWCN is the Office of Nursing Service Clinical Nurse Advisor for the Pressure Injury Prevention & Management Field Advisory Committee. She is field based at the Corporal Michael J. Crescenz VA Medical Center in Philadelphia, PA where she serves as the Wound Specialist for Geriatric and Extended Care. She has over 20 years’ experience in nursing and wound care. Shantia began her career in critical care but realized early that her passion was education and wound care. Shantia earned a BSN from Mansfield University and a MSN in Adult Health Nurse Practitioner and post masters in Family Nurse Practitioner; Nursing Education; and Wound, Ostomy and Continence nursing from La Salle University. She is a doctoral candidate (PhD) in Nursing Science at Widener University School of Nursing and a Jonas Foundation Nurse Leader Scholar (2016-18). Shantia’s passion for Veterans’ health and wound care management lead her to the VA where she currently manages Veterans with skin and wound complications. As a SME for PI prevention, Shantia assisted in the development of two new mobile apps, VA Pressure Ulcer/Injury Resource (VA PUR/release July 2017) and the Skin Check app (tentative release 2018-19). Shantia’s hopes to use her research to educate nurses on the use of mobile technology to improve health outcomes of Veterans with pressure injuries.
The Pressure Injury Prevention & Management Field Advisory Committee (PI FAC) has 10 expert members from diverse specialties from across the VA who represent all aspects of PI prevention and management at all levels of nursing and direct point of care. The PI FAC provide expert consultation throughout the VA system on PI policy and practice, education, prevention and management. The committee projects: PI Prevention Directive, PI, Skin and Wound Toolkit; CLC/CNA education, VA Pressure Ulcer Resource (VA PUR) mobile app; Skin Check app (release tentative 2018); PI education and training resource guides; and expert panel lecture education series. .
Primary Care Clinical Nurse Advisor
Cynthia Murray BN RN-BC is the Primary Care (PC) Clinical Nurse Advisor for ONS and Chair of the PC Field Advisory Committee. Ms. Murray is a Board-Certified Ambulatory Care Nurse with over 28 years of Nursing experience in varied practice settings including Critical Care, Pediatrics, Home Care, Hospice, Flight and for the past 18 years has served as an Ambulatory Care Nurse within the VHA. Cynthia obtained her Bachelor of Nursing in Nursing Research at the University of Dundee Scotland UK through the VA NNEI scholarship program. Early on in her VHA career, Cynthia identified gaps in the standardization of care in the ambulatory care setting vs the acute care setting and limited available resources in the ambulatory care fields within VHA. Through her membership with the Veterans Special Interest Group (VA SIG) of the American Academy of Ambulatory Care Nursing (AAACN), the expert body governing the resources for board certification in ambulatory care nursing, Cynthia began to volunteer her time to the development of a body of expert resources that would guide the professional practice of nurses not only in the US but globally as well. Cynthia Chaired and Edited the Scopes and Standards of Professional Nursing Practice in: Care Coordination/Transitions Management (CCTM) 2016; Ambulatory Care Nursing revision 2017 and the Telehealth Nursing revision in 2018. She was an inaugural member of the Ambulatory Care Nursing Sensitive Indicators Industry report in 2016 and the Role of the RN in Ambulatory Care position statement of 2017. Cynthia co-authored the introductory chapter of the Care Coordination and Transitions Management Core Curriculum 2nd ed, in which she provided an overview of the VHA Patient Aligned Care Team (PACT) model noting it was recommended as the benchmark for all other civilian medical home models due to its foundational concepts of team based coordinated care. Cynthia has received multiple professional and congressional recognitions related to her work advocating for high quality and accessible health care for all veterans of this nation within the communities that they call home.
The Primary Care Field Advisory Committee (PC FAC) consist of 10 primary care nursing experts from across the country and includes staff nurses, nurse managers, nurse executives and nurse practitioners. As a newly formed FAC, the team is developing resources and updating the current ambulatory care nursing ONS intranet site, PC nursing projects, provide on the spot expert consultation and participate on multiple national level committees representing the field of primary care nurses.