Office of Nursing Services (ONS)
2014 Secretary's Award Winners
Left to right: Walt C Dannenberg, Associate Director; Beth Ann Taylor, Director, Workforce & Leadership; Gloria N Martinez, Associate Director Patient Care Service/Nursing Services; Steven Becraft, Heath Care Technician; Elizabeth (Lisa) Joyce Freeman, Director
Gloria Martinez, MS, RN, NEA-BC, VHA-CM, Associate Director Patient Care Service, VA Palo Alto Health Care System
Ms. Martinez has championed the integration of nursing in the achievement of organizational goals by coordinating a 3-day VISN-wide fall reduction and education program that included staff RNs and nurse leaders from all six VISN sites, as well as ancillary staff (physicians, physical therapists, environmental management and safety services). Attendees were all able to work on facility fall prevention plans, goals of education for family, patient and all staff, equipment needs, ward/room signage, standardized language for documentation and use of fall data. As champion of the Quality priority for VAPAHCS, Ms. Martinez has had oversight and facilitated improvements in ventilator acquired pneumonia; worked with the nurse champion, infection control committee and logistics to trial a new port protector, and bundle management resulted in a decrease of infections from 14 cases in 2012 to 2 cases in 2013 - the best in the VISN.
Ms. Martinez strongly supports the VA learning opportunity residency program and has increased the number of these students at VAPAHCS from three in 2009 to seven in 2013. In moving the new graduate program from third-party managed to nursing staff managed, Ms. Martinez created opportunities for staff development in precepting, clinical expertise, public speaking, leadership and organizational skills. By using the Master’s prepared and Nurse III staff with clinical experience, the whole of nursing service becomes more professionally developed and practices with more confidence and competence. Ms. Martinez has fully supported the development of the Assistant Nurse Manager position and speaks annually at the charge nurse seminar. Ms. Martinez took an active role in soliciting nurses to apply for both local and VISN-offered leadership development programs. Since 2010, eight nurse managers and nurse leaders have completed the VISN 21 Leadership Development Institute. The national nurse education initiative funding has been prioritized in support of BSN programs since Ms. Martinez arrived at VAPAHCS. The total staff involved in a National nursing education program has grown from 12 in 2010 to 31 in 2013. Ms. Martinez was able to successfully nominate staff for both the Federal Executive Leadership and Leadership VA programs. As a VHA Certified Mentor, Ms. Martinez receives numerous requests for her mentoring and coaching skills. This past year she was the designated mentor for a mid-level manager in pharmacy service. She was the yearlong mentor of an acting Nurse Executive in our VISN. She has mentored nurse managers as part of their Master’s degree leadership program. Ms. Martinez has opened her door for staff to spend the day with her “sharing the life”, learning about and seeing the role from the Nurse Executive perspective. Ms. Martinez has been asked to mentor one of the newly appointed Nurse Executives outside our VISN this year. Ms. Martinez believes strongly in the role of mentoring and coaching as well as in the responsibility for sharing knowledge, preparing the next generation and moving the profession forward to better meet the needs of tomorrow.
Ms. Martinez has also established and maintained innovative recruitment and retention strategies resulting in significant improvement of staff satisfaction by creating a fully recognized nurse-lead Recruitment, Retention and Recognition council in 2009. She has promoted and actively participated in career development and succession planning activities including mentoring, coaching and facilitating the utilization of educational resources. Ms. Martinez prioritized the need for re-establishing/strengthening academic partnerships with BSN and graduate level programs within the San Francisco Bay Area. Over the past year, Ms. Martinez co-presented posters on the role of evidence based practice in the improvement in nursing practice as well as Project Red (re-engineering discharge) that were accepted at both local and regional educational offerings. The Summer Institute in San Antonio, Texas recognized Ms. Martinez and her staff for the outstanding work done in developing the Evidence Based Fellowship program as a key mechanism in the improvement of nursing practice at VAPAHCS.
Steven Becraft, Health Care Technician, VA Palo Alto Health Care System
Mr. Becraft (photo above) is a Health Care Technician at the VAPAHCS Fremont Community Based Outpatient Clinic (CBOC) and has demonstrated excellence in working with our returning Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans. Being an OEF/OIF Veteran himself adds to his ability to relate to this group of Veterans and allows him to act as a primary resource person for them when they first enter the system. His persistent efforts solved a complex coordination of care issue faced by the clinic when Veterans came in for a first appointment, which required multiple services by various providers who were not all located at the clinic. He met with all providers involved in this process and came up with a schedule that would accommodate all providers’ needs for scheduling purposes within a given time frame and made the Veteran's first appointment as efficient as possible.
As unit Safety Officer, he has improved patient care through incorporating relevant National Patient Safety Goals endorsed by The Joint Commission (TJC) and inspecting the environment for safety hazards (outdated medical equipment, electrical safety issues, preventive maintenance, fire extinguisher inspections, etc.). He collaborates with Biomedical Engineering, Environmental Management Service (EMS) and Sterile Processing Service (SPS) staff to ensure patient safety, and he completes/follows through on work orders.
In his role as a Health Technician, he functions on the PACT team in the place of an LVN and/or the clerk. Mr. Becraft works closely with the team RN and MD. He participates in daily team huddles and checks in patients, takes vital signs and processes clinical reminders. He provides patient teaching when needed and promptly brings any issues that need further assessment to the RN’s attention. He has consistently been acknowledged by Veteran patients for his outstanding care. He is responsible for orienting new health technicians at the Fremont CBOC. He has also met another of his goals by learning the aspects of eligibility and business office functions, which allows him to back-up the Health Administration Service employee located at the Fremont CBOC.
Tanya Peterson, BSN, MSN, RN-BC, Orlando VA Medical Center
Left to right: Tanya Peterson and Chris Engstrom, Acting Deputy Chief Nursing Officer
Ms. Peterson provides exceptional care to our Veterans at the Viera Outpatient Clinic (OPC) in the Endoscopy/Surgical Services Department. She is recognized among the staff as an outstanding nurse with a consistently positive, never too busy, pleasant, caring attitude, which is noticed by customers throughout this large, busy clinic. As a result, she was designated as the formal Nurse Liaison. Ms. Peterson possesses an extraordinary level of nursing experience, knowledge of standards and clinical skills. She is able to readily augment staffing throughout the Viera OPC. With her vast knowledge and exceptional leadership skills, she welcomes new staff members to the team and mentors them throughout their orientation and beyond.
Ms. Peterson obtained a Master of Science Degree in Nursing in 2013. She maintains national certification as a Medical-Surgical Nurse through the ANCC. Because of Ms. Peterson’s drive to improve processes, she was selected to attend Green Belt training, after which she identified a need to decrease cancellations and no shows in the Endoscopy area. She initiated a project titled, “Optimizing Access, and Maximizing Use of the Endoscopy Department”. In the first month, the no show rate decreased from 18% to 0 and the cancellation rate within 24 hours of the procedure decreased from 28% to 0. This increased the cases completed in this department by 26%. Ms. Peterson was also an active participant for Civility, Respect, and Engagement in the Workplace (CREW) for Surgical Services which greatly improved the work climate. Upon completion, the CREW facilitators sought out Ms. Peterson to become a CREW facilitator.
Ms. Peterson used evidence-based practice when providing staff information on required pre-procedure testing for Endoscopy patients. She has developed several Standard Operating Procedures (SOPs) for the Viera Outpatient Clinic using evidence–based practice. Ms. Peterson is an advocate for Patient- Aligned Care Team (PACT). She easily adopted and readily incorporated PACT model principles into practice results in assuring continuity of optimum care for our Veterans in the Specialty arena. Ms. Peterson initiated daily morning huddles in the Endoscopy Section and in the afternoon for all staff in the Surgical Services area. She has eliminated unnecessary appointments to the clinic by ensuring all required pre-procedure testing is completed for upcoming procedures when the procedure is scheduled. Ms. Peterson also attended the TEACH for Success Program for PACT, even though it is not a requirement for the Specialty area. On a daily basis, Ms. Tanya Peterson genuinely models what it means to be a VA Nurse-exemplifying true “excellence” in providing comprehensive optimal care to our Viera OPC Veterans and/or assistance to their families.
Jill Bormann, PhD, RN, FAAN, San Diego VA Medical Center
Left to right: Jill Bormann and Anna Alt-White, Director, Research & Evidence Based Practice
Dr. Bormann is the Associate Nurse Executive/Research and Clinical Nurse Specialist in Adult Psychiatric-Mental Health Nursing at the San Diego VA and an Adjunct Associate Professor at San Diego State University School of Nursing. Starting in 2001 she has pioneered a program of research on health-related outcomes of the Mantram Repetition Program (MRP), a spiritually-integrated intervention for symptom management.
Dr. Bormann's research includes Veterans with chronic illness and post-traumatic stress disorder (PTSD), family caregivers of Veterans with dementia, adults with HIV, childbearing women in labor, and healthcare employees. Her research has provided growing evidence that the Mantram Repetition Program is a "portable stress buster" easily integrated into one's life to calm the body and mind. Funding received from the National Institutes of Health (NIH) National Center of Complementary and Alternative Medicine (NCCAM), VA Health Services Research & Development (HSR&D) Nursing Research Initiative, and VA Clinical Services Research & Development (CSR&D) has contributed to the development of MRP as a viable non-pharmacological option for treatment and enabled the promotion of complementary and integrative therapies into the Veterans Healthcare System.
Dr. Bormann currently is the Pl of a two-site study (San Diego and Bedford). She also serves as a site-PI for a Traumatic Brain Injury (TBI) screening study and represents one of several sites across the nation. In 2006, Dr. Bormann served as a member of the ONS Nursing Research Advisory Group (NRAG) to help shape the strategic plan of nursing research in the VA. In 2009 she volunteered to serve as chair of NRAG for two years and was instrumental in creating a Nursing Research Directory for their website, which was recently updated in 2013. Dr. Bormann serves on the multidisciplinary Scientific Merit Review Board for Health Services Research and Development grants. She has served as a member of the local VASDHS Research and Development Committee and was nominated to serve as vice-chair of the committee
Dr. Bormann has authored 24 refereed publications, 13 refereed abstracts, and 3 book chapters on the MRP. She has delivered over 56 scientific presentations during the past 5 years including international conferences. The positive impact of the MRP on the lives of Veterans with PTSD was highlighted to showcase the innovative work by nurses on local television entitled: Vets Find Mantram Repetition Helps PTSD Symptoms and again on national television in June 2012: Need to Know: Nursing the Wounded. Dr. Bormann was the only nurse invited to chair a panel on complementary therapy research at the Annual Research Meeting of the Academy Health in June 2013 and was an invited plenary speaker for the 2013 Association of Professional Chaplains conference. She is well positioned to continue having a significant impact on the image of nursing by mentoring the next generation of nurses through her affiliations with the University of San Diego and San Diego State University schools of nursing.
Perla Arreola, LPN, Albuquerque VA Medical Center
Ms. Perla Arreola recognizes customer service as a central factor to the successful delivery of quality healthcare in a multispecialty surgical clinic and within the VA system at large. She embodies the Veteran Centered Care model by placing a premium on Veterans and their experience with the Surgical Service. She demonstrates passion, intelligence, caring and creative problem solving in both direct patient care and process improvement.
After reading an AJN article on pharmacologic management of osteoarthritis-related pain in older adults, she collaborated with the pharmacist and orthopedic surgery providers to improve the delivery of Synvisc injections within the clinic. Because of a challenging approval process for this non-formulary medication, Veterans typically had to make a second appointment once they were prescribed the treatment. As a result of her successful efforts, 95% of Veterans prescribed Synvisc can now receive their injection the same day. The resulting reduction in repeat appointments has directly improved access to orthopedic care for other Veterans.
Ms. Arreola works with the Registered Nurse leadership within Surgical Service to lead a staff of mostly health technicians, developing team momentum, enthusiasm and pride. She makes assignments that meet the needs of the clinic and matches the right people with complementary skills to maximize team effort. She encourages even the less vocal team members to participate in process improvement practices at the unit level, ensuring that every voice is heard, which has led to measurable improvement in the clinic.
Ms. Arreola served as the junior member of a Rapid Process Improvement Workgroup tasked with improving the access to orthopedic care for Veterans. As a member of this dynamic team, she effectively weighed risks, made objective observations and took decisive action to reduce the average delay in days from consultation to first appointment from a high of 83 days in January 2013 to an average of 10 days in July 2013. As a team member, she proposed innovative and practical solutions including clinical video teleconferencing and electronic consultation to improve access and increase veteran satisfaction.
Ms. Arreola is currently enrolled in the BSN program at Grand Canyon University. She serves as a mentor to three other clinic health technicians who are actively engaged in prerequisite courses toward nursing, assisting them with completing education reimbursement funding paperwork and meeting in group study sessions. She encourages other peers in the clinic to further their education as well. She is self-directed in carrying out very complex practical nursing care assignments. In 2013, Ms. Arreola was recognized by her peers and Nurse Leaders state wide and awarded the prestigious title of Excellence in Practice award in the category of Ambulatory Care. This distinction was remarkable as an LPN in a category dominated by Registered Nurses who themselves have been honored for their practice and achievements.