Read East Tennessee Children's Hospital's 2013 Nursing Annual Report to see how dedicated our nurses are to caring for children.

2. Our nurses
in action

3. Dear nursing colleagues and friends,
It’s no secret that in so many ways nurses are the heartbeat of East Tennessee
Children’s Hospital. Every day, in every department, our nurses are on the
front lines—helping save lives and making important decisions that affect
the health of thousands of children. Last year was an incredible one for our
nurses—filled with continued growth and opportunities, as well as challenges
that our staff met with compassion, knowledge and dedication. I’m proud to
share some of the many ways our nearly 450 nurses made a difference in this
year’s nursing annual report. Using hospitalwide data, this report highlights
some of the accomplishments our nurses achieved from January 2013 to
December 2013.
As you read the report, you will see that our nurses and their tireless
dedication to their profession are making an impact in our hospital and
beyond. The family-centered, pediatric-focused care they bring to our patients
helps make Children’s Hospital the special place it is. I’m honored to not just
serve as a leader for our nursing staff, but to learn from them and witness the
compassion they show our young patients every day.
Sincerely,
Laura Barnes, M.S.N., R.N., N.E.A.-B.C.
Vice President for Patient Care Services and Chief Nursing Officer
3

4. Seeing our nurses in action
Though their most important role is serving at the bedside of our young patients and
ensuring they receive the best possible care, our nurses are thriving and making an
impact at Children’s Hospital in other ways. They’re seeking educational opportunities to
help them stay at the forefront of nursing. They’re providing input about the upcoming
hospital expansion that will enable us to better care for East Tennessee’s children. If it
affects their daily duties and the children they care for, our nurses want to be part of it.
In 2013, we launched our professional practice model (PPM). Represented visually by a
pinwheel, the PPM signifies how nurses at Children’s Hospital practice, communicate and
collaborate to provide the highest-quality care for our patients. At the core of the
pinwheel, of course, are our patients and their families, with all components moving
in concert around them, supported by our strong philosophy
of family-centered care. The PPM represents our
nurses in action as we continuously respond to
the needs of our patients and the environment.
The pinwheel’s petals symbolize the many
components that are important to our practice
as nurses, including core values, shared
decision-making, exemplary practice,
professional growth and empowerment to
improve. A pinwheel is especially appropriate
because it is always moving, much like our
strong nursing staff who are always adapting
to the needs of the patient and changes
in health care.
We’re not the only ones noticing our
strengths. In 2013, Children’s Hospital received the
Tennessee Nurses Association’s Outstanding Employer
Award. This is the first time Children’s Hospital has received
the award from the association, a professional organization
representing nurses throughout the state. This award is especially
important because it recognizes our nurses and the passion they
bring to work each day.
Exemplarypractice
growth
Professional
Em
powered
to
improve
Shared
decision-
making
N
ursingcore
values
Family-centeredcare
Patient
family
4

5. It also spotlights the hospital’s support of nurses and nursing excellence. The
selection process for the award is specific and highlights many of our hospital’s
strengths, including encouraging nurse representation on decision-making
bodies, having policies and procedures that permit nurses to express their
concerns regarding their professional practice environment and having leaders
who are dedicated to improving the quality of nursing by contributing to nursing
professional development.
The work of our nurses and staff was also recognized on a national level in 2013,
when The Leapfrog Group included us on its 2013 list of Top Hospitals. Children’s
Hospital was one of 13 pediatric hospitals honored for setting the highest
standards in safety and quality. Out of all the adult and pediatric hospitals in the
U.S. receiving the award in 2013, we were the only hospital in east Tennessee and
one of only five in the state.
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6. 6

7. Empowered to improve
I am a Children’s Hospital nurse. I have control of my practice,
and I know I can improve quality in patient care.
We take pride in patient safety and infection prevention. We measure patient safety in a
number of different ways. The following data is a sampling of some of the most common
types of potential safety issues associated with a child’s stay at Children’s Hospital.
Pediatric Intensive
Care Unit (PICU)
0 in 2013
1 in 2012
Neonatal Intensive
Care Unit (NICU)
2 in 2013
1 in 2012
Central line-associated blood stream
infections (CLABSIs)
Because central lines are used for longer
periods of time, we have to work hard to
make sure they do not become infected,
which can be very serious.
How we are improving: Using nursing
research and literature to identify best
practices, we have implemented standard
ways to insert and maintain central venous
catheters to prevent CLABSIs.
Pediatric Intensive
Care Unit (PICU)
0 in 2013
0 in 2012
Neonatal Intensive
Care Unit (NICU)
0 in 2013
0 in 2012
7
Ventilator-associated pneumonia
Because this type of pneumonia results
from microorganisms that invade the
lower respiratory tract and lungs, care
must be taken to prevent infections.
How we are improving: We participated in
regional efforts and developed standards to
eliminate this type of pneumonia, which is
the second most common hospital-acquired
infection in Pediatric Intensive Care Units.

8. Solutions for Patient Safety
In January 2013, Children’s Hospital became a collaborative partner in Solutions for
Patient Safety (SPS). There are 78 children’s hospitals across the country that participate
in the collaborative, which was founded in 2008 to create universally safe and healing
environments for all children in the care of U.S. pediatric hospitals. Through an
interprofessional approach to improving care, the collaborative empowers staff to
improve through open discussion, transparency and learning of best practices. Team
leaders, who include medical staff, respiratory therapists, clinical nurses, utilization
review staff, pharmacists, physical therapists and nutritionists, are working in eight
areas of concentration. The goal is zero harm to our patients.
Our team leaders include:
• Loretta Maples, B.S.N., R.N., Nursing Director of Support Services: Adverse drug
events (ADE)
• Bill Chesney, B.S.N., R.N., Staff Development Specialist, Pediatric Intensive Care
Unit (PICU): Ventilator-associated pneumonia (VAP)
• Barb Barr, M.S.N., R.N., Nursing Director, Perioperative Services: Surgical-site
infections (SSI)
• Ali Gonzalez, B.S.N., R.N., C.P.N.: Falls prevention
• Judy Marciel, M.S.N., R.N., Clinical Nurse Specialist: Pressure ulcers prevention
• Pam Myers, B.S.N., R.N., C.M.L., Nurse Manager, PICU: Central line-associated
blood stream infections (CLABSIs) and catheter-related urinary tract infections
(CAUTI)
• Laura Barnes, M.S.N., N.E.A.-B.C., Vice President for Patient Care Services and
Chief Nursing Officer: Serious safety events (SSE)
Through the work of these teams, Children’s Hospital met the goal of reducing harm
to children by 20 percent from 2012 to the end of 2013.
Catheter-associatedurinary tract infections2 in 2013
4 in 2012
Falls with moderateor greater harm
1 in 2013
4 in 2012
8
Pressure ulcers
Stage 3 and above
5 in 2013
11 in 2012

9. 9
2013 Leadership Summit
At Children’s Hospital, we strive to empower our nurses to improve the patient care they
provide by seeking new and innovative approaches to their work. Several nurses from
Children’s Hospital presented their work for improving care at the 2013 Leadership
Summit sponsored by the Tennessee Center for Patient Safety and the Tennessee
Hospital Association.
Podium presentations from our nurses included:
• Carla Saunders, N.N.P., N.N.C.: NAS – Nurse Practitioner Lead Quality Improvement
Project
• Brandy Payne, B.S.N., R.N., C.P.N., and Lauren Baumgardner, B.S.N., R.N.C.-N.I.C.:
Journey to Becoming a Safe Sleep Hospital
In addition, poster presentations included:
• Tracie Savage, R.N.C.-N.I.C., and Sonya McGill, B.S.N., R.N.C., N.I.C.:
Creating a CLABSI-free Culture in the Neonatal Intensive Care Unit
• Kary Pickard, R.N., and Kristen Powell, R.N.: Creating a VAP-free Culture in the
Neonatal Intensive Care Unit
• Sara Matalik, B.S.N., R.N.; Barbara Barr, M.S.N., R.N.; Jennifer Smith, B.S.N., R.N.;
and Judy Marciel, M.S.N., P.C.N.S-B.C., C.P.N.P.-B.C., C.W.C.N.:
Improving Patient Safety Through the Implementation of the Perioperative
Safety Passport
• Sherry Edwards, B.S.N., R.N., C.P.N.: Welcome to the Jungle – A Communication
Initiative
• Betty Gregg, R.N., C.P.N.: Hello, Halo. Fostering Performance through Education
and Collaboration
• Sarabeth Mayo, B.S.N., R.N.: Performance Excellence in Action – A Perioperative
Council Collaboration
• Gina Shelley, R.N., C.P.N.: Communicating for a Better, Safer Tomorrow
Patient safety is a
priority in this organization.
Our nurses: 4.55
overall score—out of 5
National average: 4.46
Source: 2013 employee engagement survey

10. 10

11. Exemplary practice
I am a Children’s Hospital nurse. I provide care that meets
our patients’needs and exceeds standards.
Providing palliative care
When a child is seriously ill, it affects him and his caregivers in a profound way.
Palliative care helps improve quality of life for the entire family by providing
relief from the pain and stress of a serious illness and improving communication
and coordination of care. In October 2013, in conjunction with Children’s
Anesthesiologists, Lorna Keeton, M.S.N., C.P.N.P., joined the Children’s Hospital
Palliative Care Program as the Pain/Palliative Care Nurse Practitioner.
In the last three months of 2013, Keeton consulted on 46 patient cases, including
11 that required palliative care. In addition to treating patients, Keeton works with
nursing staff to educate them about the importance of palliative care.
To provide the best care for our seriously ill
patients, Keeton and the Palliative Care Committee
meet quarterly to work on policies and procedures,
the Precious Print Program and a process for just-
in-time staff support in response to crises related to
emotional needs and debriefing.
11
This organization provideshigh-quality care and services.
Our nurses: 4.47
overall score—out of 5
National average: 4.31Source: 2013 employee engagement survey

12. 12

13. 13
Professional growth
I am a Children’s Hospital nurse. I have opportunities to develop
skills to both better myself and the care I deliver to patients.
Recognizing Excellence At Children’s Hospital (REACH)
REACH is a program designed to recognize the individual work that our nurses do each
day. REACH offers four levels of achievement—each has required skill and educational
requirements.
• Level I – Entrance Nurse
• Level II – Proficient Nurse
• Level III – Skilled Nurse
• Level IV – Outstanding Nurse
Currently, the majority of Children’s Hospital nurses are Level II—unless they are new
graduates, and then they must wait a year before participating in REACH.
Level III
Meaning they must have the following: a nursing specialty
certification and/or bachelor’s of science in nursing degree,
a minimum of one year of nursing experience and all the
required activity points.
Lauren Baumgardner, B.S.N., R.N.C.-N.I.C.
Karen Beeler, B.S.N., R.N.C.-N.I.C.
Bonnie Estes, B.S.N., R.N.
Ali Gonzalez, B.S.N., R.N., C.P.N.
Dana Hickey, B.S.N., R.N., C.P.N.
Carol Hudson, B.S.N., R.N., C.P.N.
Becky LeMarbre, B.S.N., R.N., C.C.R.N.
Denise Majors, B.S.N., R.N.
Amanda Parrott, B.S.N., R.N., C.P.E.N.
Brandy Payne, B.S.N., R.N., C.P.N.
Charla Purkey, B.S.N., R.N.C.-N.I.C.
Joyce Riddle, B.S.N., R.N., C.P.N.
Jennifer Schlomer, B.S.N., R.N.C.-N.I.C.
Debra Schmid, B.S.N., R.N., C.P.N.
Krystle Silva, B.S.N., R.N.
Linda Welch, B.S.N., R.N., C.P.N.
Level IV
Meaning they must have the following: a nursing
specialty certification, at least a bachelor’s of science
in nursing degree and the required number of
activity points.
Becca O’Connor, B.S.N., R.N., C.P.E.N.
Esther O’Hare, I.B.C.L.C., C.F.N.P.
Emily Savage, M.S.N., N.N.P.
New degrees
Nancy Bunch, B.S.N.
Emily Collins, B.S.N.
Peggy Grindstaff, B.S.N.
Amanda Martin, M.S.N.
Emily Oram, M.S.N.
LaTosha Phillips, B.S.N.
Ron Phillips, B.S.N.
Carol Smith, B.S.N.
Jennifer Smith, B.S.N.
Lori Smith, B.S.N.

14. 14
Certifications
American Nurses Credentialing Center
(ANCC)
Betty Gregg
Critical Care Registered Nurse
Susan Miller
Laura Tilley
Certified Pediatric Emergency Nurse
Wayne Baxter
Judy Lane
Amanda Parrott
Sharyn Styles
Rebecca Trout
Certified Pediatric Hematology
Oncology Nurse
Emily Denton
Lawana Evans
Certified Professional in Healthcare
Quality
Janice Mays
Certified Pediatric Nurse
Justin Abbot
Lacey Beeler
Tomica Bellamy
Tabatha Burrell
Jennifer Campbell
Karen Carson
Veronica Doane
Jennifer Essary-Matthews
Lauren Fisher
Amy Gilliland
Liza Graves
Jill Green
Kimberly Hill
Kelsey Horner
Lisa Johnson
April Jones
Martha Jordan
Stephanie King
Cady Kington
Olivia Lawless
Julie Leonard
Samantha Lowry
Leshia Walker Martin
Ashley McNeilly
Carrie Millsaps
Sara Norton
Jody Ohsiek
Sandra Partilla
Jennifer Quintois
Gail Rich
Kelly Rivers
Brittany Rowe
Tierra Salyers
Carol Seagroves
Deb Sharp
Kimberly Shelton
Connie Smith
Nancy Timm
Jennifer Wacks
Donna Wallace
Barbara Westbrook
Certified Pediatric Oncology Nurse
Karen Johnson
Certification for Neonatal Intensive
Care Nurse
Lauren Baumgartner
Karen Beeler
Anna Hawkins
Mindy Irick
Corie Jones
Charla Purkey
Casey Reynolds
Tuesday Scalf
Jennifer Schlomer
Kelly White

15. 6 percent increase
in nurses who
received a
higher degree
9 out of 10 nursingunits had an increasein certifications
This organization provides career
development opportunities.
Our nurses: 3.97 overall score —out of 5
National average: 3.84
Source: 2013 employee engagement survey
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16. 16

17. Shared decision-making
I am a Children’s Hospital nurse. I have autonomy to
deliver excellent patient care. Every nurse is a leader with
collaboration across disciplines to improve patient care.
17
Council leadership
Clinical Informatics
Chair: Vicki Collins, B.S.N.
Coordinating
Chair: Crystal Blake, R.N., C.P.N.
Engagement
Chair: Nancy Griffin, R.N.
Co-chair: Veronica Doane, B.S.N., R.N.
Leadership
Chair: Laura Barnes, M.S.N., N.E.A.-B.C.
Magnet Steering
Chair: Karen Burchfield, M.S.N., R.N., C.P.N.
Night Shift
Chair: Melissa Veach, B.S.N., R.N.
Co-chair: Tanya Belcher, R.N.
Nursing Practice Improvement
Chair: Ali Gonzalez, B.S.N., R.N., C.P.N.
Co-chair: Melissa Keasler, R.N.
Clinical Practice and Standards
Chair: Chris Tolliver, M.S.N., R.N., C.P.N.
Professional Development
Chair: Donna Wallace, B.S.N., R.N., C.P.N.
Co-chair: Christina Curry, R.N.
Research Council
Chair: Lauren Lisa, B.S.N., R.N., C.P.N.
Co-chair: Stephanie Roberts, R.N.
The environment at this organization
makes employees in my work unit
want to go above and beyond what’s
expected of them.
Our nurses: 4.60 overall score—out of 5
National average: 3.57
Source: 2013 employee engagement survey

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19. 19
Nursing core values
I am a Children’s Hospital nurse. I use my core values, including
quality and safety, professionalism, integrity, stewardship,
compassion and innovation, as my foundation for providing care.
Daisy Award winners
Stephanie Brock, R.N.
Katelyn Hodge, B.S.N., R.N.
Janice Rivers, B.S.N., R.N.
Brandy Payne, B.S.N., C.P.N.
Jennifer Quintois, B.S.N., R.N.
Lauren Wilson, B.S.N., R.N., C.P.N.
Chad Tapp, B.S.N., R.N.
Joyce Riddle, B.S.N., R.N., C.P.N.
Becca Troutt, R.N., C.P.E.N.
Janet Williams, R.N.
Clinical Excellence Award winners
Deena Cantrill, B.S.N., R.N.
Maggie Dickson, R.N.
Kelly Filyaw, B.S.N., R.N.
Betty Gregg, R.N.-B.C.
Dana Hickey, S.N., R.N.
Megan Jones, R.N.
Melissa Marsee, B.S.N., R.N.
Lauren Wilson, B.S.N., R.N.
I would recommend this organization
to family and friends who need care.
Our nurses: 4.60 overall score—out of 5
National average: 4.33
Source: 2013 employee engagement survey

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