1. May, 2016
From the Top of the Hill
Cleveland Clinic
Hillcrest Hospital
Sue Collier, DNP, RN, NEA‐BC
Chief Nursing Officer
Please enjoy our “Spotlight On” series as we take the opportunity to recognize individuals who make a posi ve difference
in the lives of our pa ents and our team. Know someone to shine the spotlight on? Be sure to forward their name and
informa on to Ken Stahorsky, MBA, RN at stahork@ccf.org and Chris O’Brien, RN, IBCLC at cobrn@ccf.org.
June, 2016
From the Top of the Hill
Cleveland Clinic
Hillcrest Hospital
Rosa Johnson, MS, BSN, BA, RN‐BC, OCN
A nurse since 1968, Rosa Johnson, MS, BSN, RN, RN‐BC, OCN has a wide range of bedside nursing experience in
orthopedics, neurology, urology, and gynecology, oncology, and medical/surgical. Her passion for nursing is
founded on her desire to help pa ents and their families, and teach others about nursing. During her 30 years at
Huron Hospital, she was the ANM in Orthopedics under then Nurse Manager, Sue Collier, DNP, RN, NEA‐BC.
Rosa joined Hillcrest in 1996 as an ANM in the Oncology Department and worked hard to become cer fied in
two special es, gain her BSN, and Masters in Management. Her drive to further her educa on stems from a love
of learning and, as she states, “I wanted to get my educa on to lead—because I feel you’re a be er leader if
you’re be er educated.”
Rosa is ac vely involved as a volunteer at Fairhill Partners and has presented twice to seniors raising their
grandchildren on “Successful Aging” and “Immuniza ons for Seniors.” She is a facilitator for the Catch Program at Camp Fairhill
Partners Kinship Summer Camp, teaching children age 9‐12 about nutri on. As part of a research team, she recently completed an IRB
study tled “Adherence to Medica ons in a Cardiology Prac ce,” and has been featured in Minority Nurse magazine in 1997, and
Cleveland Magazine and the Greater Cleveland Nurse Associa on magazine “Faces of Nursing,” both in 2009. In 1993, Rosa was the
first nurse to be recognized as Huron Hospital’s “Outstanding Nurse” by the surgical residents. She won the same award the next year
from the medical residents. In 2003, Rosa was inducted into the Hillcrest Nursing Hall of Fame and won the Oncology Nursing Society
Cleveland Chapter Shirley Gullo Award in 2004. Rosa currently works in the Hillcrest Float Pool because she enjoys “working with a lot
of people throughout the hospital.” When asked about her career in nursing, Rosa commented that “Learning in nursing is life‐long. I
love helping people and making them laugh. That’s where the care is…at the bedside. If you love what you do, it shows.”
Ildiko Yuryev, RN
While finishing her BSN and planning to start her MSN in the fall, Ildiko Yuryev, RN of the Observa on Unit
is the current president of the Ohio Student Nurses Associa on (OhSNA) and recently won the Isabel
Hampton Robb award. This is a very pres gious na onal award recognizing leadership characteris cs
embodied by Isabel Hampton Robb, a visionary leader known for establishing the nursing organiza ons
which evolved into the American Nurses Associa on (ANA), the Na onal League for Nursing (NLN), and the
Interna onal Council of Nursing (ICN).
Ildiko states that “this is the highest award for leadership excellence that student state presidents are
eligible for, and this year Ohio was the winner.” She further says “involvement in professional organiza ons
was the best decision I have ever made. It made a difference in my life, and in the lives and careers of
others who chose to help Ohio and OhSNA write history. I have had the pleasure of mee ng many talented
and passionate individuals along my journey.”
Ac ve in many organiza ons throughout her academic career, including Phi Theta Kappa Interna onal Honor Society of two‐year
colleges, Ildiko received numerous awards recognizing her leadership abili es, academic excellence, and service record. She served as
president of Cuyahoga Community College's Student Nurse Associa on, the 2014‐2015 Breakthrough to Nursing Director for the Ohio
Student Nurses Associa on, and was inducted into Sigma Theta Tau Honor Society of Nursing in April, 2016. She recalls that a mentor
once implored her to remain involved in organiza onal leadership. As a result, Ildiko states “in a short me I grew into a leader and a
professional. My network encompasses not only the state of Ohio, but the leadership of all currently ac ve states.”
Nursing Excellence
National Award Winner

2. Cleveland Clinic
Hillcrest Hospital
2
Academic Achievements
Sarah Koenigseker, MSN, BA, RN, CNM (new CNM) – L&D
Marie Novak, BSN, RN, CMSRN (new BSN) – 5 ST
Caitlyn Way, BSN, RN (new BSN) – ICU
New Cer fica ons
Jessica Gorse, BSN, RN, CCRN (new CCRN) – CSICU
Sharon Knop, BSN, RN, CLC, RNC‐MNN, CKC (new CKC) – M‐B
Judy Lamb, BSN, RN, CKC (new CKC) – NICU
Donna Luxenburg, BSN, RN, MNN (new MNN) – FMC
Sara McKee, BSN, RN, CKC (new CKC) – L&D
Karen Presco , MSN, RN, CNOR, CKC (new CKC) – L&D
Brooke Sinha, BSN, RN, SCRN (new SCRN) – 4MT
Angela Sotka, BSN, RN, CPAN (new CPAN) – Periop
Jerica Tokic, BSN, RN, MNN (new MNN) – FMC
Melissa Zakelj, RN, CNOR (new CNOR) – OR
Publica ons, Posters, and Podiums
Podium Presenta ons
Laura Drobnich Sulak, MS, BSN, RN and Ken Stahorsky, MBA, RN
presented “Using Simula on Educa on with Older Pa ents to
Reduce the Risk of Falls in the Home” at the Interna onal Nursing
Associa on for Clinical Simula on and Learning Conference on
June 15‐18, 2016 in Grapevine, TX.
Poster Presenta ons
Melissa Richardson, MSN, RN, SCRN presented “Redesigning the
Informa on Highway—Using Video to Improve Nurse Sa sfac on
with Pa ents’ Transi ons from the Emergency Department to the
Neuroscience Unit” at the Ohio Associa on Quality Summit on June
15, 2016 in Columbus, OH.
Sandra Zampino RN, Rose Hosler BSN, RN, HNB‐BC, Karen Ellen
Fink, BSN, RN, HNB‐BC, Karen Brown, RN, Barbie Picciano, RN, HN‐
BC, and Rosslyn Van Den Bossche, MBA, RN, NE‐BC presented
“Reiki and Manual Therapy Educa on for Nurses: Integra ng
Holis c Care at the Bedside to Enhance Nurse‐Pa ent
Interconnectedness” at the American Holis c Nursing Associa on
Conference on May 31‐June 5, 2016 in Bonita Springs, FL.
Congratula ons
Congratula ons to Veronica
Uko c, BSN, RN, our new Nurse
Manager for 5 Main Tower.
Veronica received her BSN from
Ursuline College where she is
currently pursuing her MSN. She
started her nursing career as an
LPN on a Medical/Surgical unit,
then as an RN in the ED, a NOM at
Euclid Hospital for seven years,
then a night shi NOM at Hillcrest
for over four years. Please join us
in congratula ng Veronica!
Welcome New Hires & Internal Transfers
As of May, 2016
Cri cal Care Units
ICU CSICU
Alexis Baroni - PCNA Judy Oster, BSN, RN
Jennifer Brobst, BSN, RN
Cynthia Kume, BSN, RN
Bianca Walton - PCNA
Medical/Surgical Units
3MT 4WT
Haley Crncic - PCNA Brooke Huston - PCNA
Taylor Farmer - PCNA Teresa Myles - PCNA
Gina Lovano - PCNA Samantha Santana - PCNA
Rachel Skillman - PCNA
4MT
Skye Rupnow - PCNA 3ST
Milleon Douglas, RN Lisa Heini - PCNA
Amanda Harrison, RN Fawn Metzung - PCNA
Alexis Levy, RN Jessica Smith, BSN, RN
Mary Paoloni, RN
Winfield Such, BSN, RN 5ST
Talea Steward - PCNA
5MT
Lauren Moran - PCNA OBS
Marcia Siggers-Nixon - PCNA Courtney Davis, RN
Samantha Tuttle, RN Megan Kuhlman, BSN, RN
3WT 3WT
Laura Christy - PCNA Lauren Walsh - PCNA
Kellie Grant - PCNA Jennifer Wyrock - PCNA
Surgical Services
OR
Danielle Harris, RN Trisha Maheu - Surg Tech
Taylor Mullan - Surg Tech
Emergency Department & Services
Adult Peds
Ruslan Astakhov, RN Tierney Bryant - Paramedic
Daniella Corbin - PCNA Janet Williams - PCNA
Women & Children’s Services
FMC NICU
Barbara Bartel - PCNA Allyssa Carroll - PCNA
Danielle Eustace - PCNA Colleen Roth - PCNA
L&D
Anne Hahn, BSN, RN
Allison Wainio, BSN, RN
Other Nursing Areas
Float Pool Gyn Oncology
Tyler Danielson - HUC Patrice Fleckenstein - Care Coord
Float Pool
Kristy Rostocil, BSN, RN

3. Cleveland Clinic
Hillcrest Hospital
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News from Nursing Congress
By Amy Berardinelli, MSN, RN, CPAN, Tina DiFiore, APRN, MSN, RN, NNP‐
BC, Annie S bich, BSN, RN, RN‐BC, and Toni Zito, MSN, RN, CPAN.
May facilitator: Caitlyn Way, BSN, RN
CNO Update
Purposefully hourly rounding is an evidenced‐based approach to
delivering top pa ent care because it affects the pa ent
experience, directly impac ng quality, and pa ent safety. A new
video was created about hourly rounding which every inpa ent
caregiver is required to view.
HR Connect will be replaced by Work Day later this summer,
which can be accessed via home or cell phones.
Vital Scout is posi vely impac ng pa ent care. The me span
from PCNAs taking vital signs to when they are recorded in EPIC
has decreased by 46%, which also leads to a quicker nursing
reassessment.
Na onal Teaching Ins tute Annual Conference (NTI)
By Doug Klier, BSN, RN, PCCN
The conference theme, “It ma ers, I ma er, my contribu ons
ma er,” was chosen to bring a en on to the fact that our
contribu ons as nurses and our work environment ma ers if we
are to meet the needs of pa ents and families.
Hillcrest CCU was recognized for receiving the Beacon Award for
Excellence.
Research shows that if we do not act on an idea within ten
seconds, our brain will move on to another idea or topic. By
incorpora ng the concept of “5‐4‐3‐2‐1‐GO,” a countdown to
ac on, we can overcome fear and be more produc ve.
Introduc on to NICHE
By Lynn Szoka, MSN, RN, APN, GCNS‐BC
Hillcrest is a Nurses Improving the Health Care of Elders (NICHE)
hospital. NICHE is the leading, nurse‐driven program that helps
hospitals and healthcare organiza ons develop strategies to
improve care for older adults. Hillcrest’s NICHE designa on
demonstrates our commitment to improve quality, enhance the
pa ent and family experience, and support excellence in the
communi es we serve. Some current Hillcrest ini a ves include
decreasing falls, care coordina on, and encouraging family
par cipa on in pa ent care decisions.
NICHE Conference Highlights:
Discussion of healthcare reform and how nurses, and NICHE, fit
into this new paradigm.
Strategies for improving care delivery and communica on,
elimina ng waste, and focusing on outcomes and preven on.
Developing transi onal care models to ensure healthcare
con nuity, and improving outcomes for at‐risk popula ons.
Shared Governance
Strategies for Dealing with Difficult Co‐Workers
By Meri Gilman‐Mays, DNP, CRNA, RN
An important quality to develop in today’s healthcare environment
is resilience. Resilience is the capacity to recover quickly from
difficul es; toughness. Healthcare is a stressful profession which is
physically, emo onally, and mentally demanding. In order to care
for others, it is crucial to take good care of yourself. This requires
developing basic resiliency skills like cul va ng an op mis c
a tude, overcoming stress, and taking me for recrea on.
Working in healthcare can be compared to fish swimming in the
ocean. Although fish are unique, each with different personali es
and traits, all swim in the same water. As co‐workers, we bring to
the work environment our own personali es and traits, but we
likewise pursue the same goal, namely, to provide exemplary
pa ent care in an acceptable work environment.
Keys to Developing Resilience:
A tude—Choose to maintain an op mis c outlook on life; one
of hopeful expecta on for posi ve results. Be flexible and
inten onally look for the best outcome.
Stress Management—Life is naturally stressful, so learn how to
take purposeful ac on to control outcomes. Set limits to manage
stress by “unwinding” via exercise, medita on, or a walk.
Enjoy Life—Make an inten onal choice to enjoy life through
increased par cipa on. Accept the fact that, on some days, you
may not "feel" like going to work, cleaning the house, or
a ending a party, but push forward to get it done.
Focus on Yourself—Only you can change your reac ons. Stop
and look at all the wonderful things around you. Everything
begins with the words you direct toward others.
Remember that everyone wants to be recognized. Each day should
provide a sense of accomplishment and joy. This means that it is
important to have fun while ge ng things done. Life’s
accomplishments and joys do not have to be sensa onal and may
be as basic as making the bed or pe ng the dog. It is the
apprecia on of simple things that keeps life in balance.
HEALING ENVIRONMENT COUNCIL
Co‐chaired by Lynda Warren, BSN, RN, RNC‐LRN and Rose Hosler, BSN, RN,
HNB‐BC. Nursing Leadership support by Kathy Saffron, MSN, RN, NE‐BC.
 Working on the Fragrance policy and standardizing HUSH and
Pain Baskets to be maintained on each unit
 Several council members presented “Code Lavender,” a rapid
emo onal response to support pa ents, families, and caregivers
experiencing hardship, at the recent Pa ent Experience Summit
QUALITY & PATIENT SAFETY COUNCIL
Chaired by Doug Klier, BSN, RN, PCCN and Lynn Szczepinski, BSN, RN,
PCCN. Nursing Leadership support by Sue Sturges, MSN, RN, NE‐BC, CNS.
 Currently looking at ideas to improve medica on reconcilia on,
pa ent transfers, and pa ent falls

4. Cleveland Clinic
Hillcrest Hospital
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PROFESSIONAL DEVELOPMENT & EDUCATION COUNCIL
Co‐chaired by Lindsey White, BSN, RN, RNC‐NIC and Hilary Marks, BSN, RN,
IBCLC. Nursing Leadership support by Mary Bartos, MSN, RN, NEA‐BC,
APCNS.
 Working on ideas to increase professional RN cer fica on rate
 Planning con nues for the Professional Development
Conference scheduled for October 14, 2016
 Career Ladder le ers of intent process is now complete and
eligibility verifica on has started
RESEARCH AND EVIDENCE-BASED PRACTICE COUNCIL
Chaired by Meaghan Oblak, BSN, RN and Heather Dicioccio, MSN, RN, RN‐
MNN. Nursing Leadership support by Nancy Albert, PhD, CNS, RN.
Several ongoing nursing research projects underway at Hillcrest
Remember that the Cleveland Clinic has educa on and
mentoring support for those interested in research
NURSING PRODUCTS EVALUATION COMMITTEE
Laura Sustar, BSN, RN, VA‐BC and Michele Smith, BSN, RN represent
Hillcrest on the Enterprise Wide Product Evalua on Commi ee.
Pulse Oximeter Probe Recycling—The recycling vendor will soon
change; the overall process will not change
J Loop—Because of difficul es with the new J Loop IV connector
within the Enterprise, we will convert back to the former
product; alterna ves are currently being evaluated
Sani‐Hands wipes will be rolled out across all care areas and
placed at every pa ent’s bedside for pa ents to use as needed;
especially a er the restroom and before meals
New Sharps containers to be rolled out soon
UNIT-BASED UPDATES
ICU: By Caitlyn Way, BSN, RN
Shared Governance Accomplishments:
 Hillcrest’s ICU recently held a caregiver‐to‐caregiver open house
invi ng other nursing areas to visit the ICU to learn about the
unit and meet the caregivers
 Using an educa on board lis ng all offerings for 2016
 Created an ICU Facebook page
 The ICU Shared Governance Commi ee sends birthday cards to
all caregivers
 Crea on of a “Welcome Bag” given to all new ICU nurses;
includes an invita on to join Shared Governance
Cancer Center: By Vanessa Ryks, RN, OCN
Shared Governance accomplishments:
 Development of “Call Off” guidelines
 The Cancer Center averages 695 calls per week ranging from
emergency to medica on ques ons. A new phone process
routes calls more efficiently and minimizes hold mes.
When a Rapid Response or Code
Blue occur, simply click on the on
the “Code/Rapid Response” bu on
in the “Vital Scout” note. This auto‐
ma cally changes the pa ent to
RED and creates a banner visible on
the pa ents chart. Con nue Code/
Rapid Response documenta on on
the paper forms.
From the “Med Surg
Navigator > Vital Scout
Assess”, you can escalate
your pa ent to a higher
acuity level based on your
Nursing Judgment.
Vital Scout Quick Tips
2016 Quarter 2 Daisy Award Winner
Congratula ons to Becky Baker, RN, OCN
of the Cancer Center for winning the
2016 first quarter Daisy Award. As noted
by Terence Gutgsell, MD and Julia Miller‐
Lemon, CNP who nominated Becky for
the award, “She is truly an extraordinary
nurse who goes above and beyond for
her pa ents at the Hillcrest Cancer
Center. Her compassion is unwavering
but it's her pa ent advocacy and
a en on to detail that really set her
apart.” Way to go, Becky!
Every effort is made to be accurate and apologizes in advance for any omissions and/or errors. Please submit any such discrepancies and/or article contributions to Ken Stahorsky at
stahork@ccf.org. Top of the Hill Editorial Board reserves the right to edit all submissions. Thank you.
Cleveland Clinic Enterprise is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

5. Cleveland Clinic
Hillcrest Hospital
5
Through the Eyes of the NOMs
By Nancy McMillin, BSN, RN
So, what does a NOM do? Before I answer that, let’s look back at
the role and how it has changed. About 20 years ago, a pager was
given to a senior cri cal care nurses who worked nights. This
nurse, usually the charge nurse, was also given the responsibility to
be the resource person for other nurses, facilitate pa ent
transfers, and handle unusual situa ons.
This expanded role, which turned into the Administra ve Pa ent
Care Coordinator (APCC) posi on, con nued to evolve in
partnering with staffing, admi ng, ANMs, and charge nurses to
ensure a smooth flow of pa ents transferred internally from the
ED to nursing units or externally to other healthcare facili es. At
Hillcrest, an APCC group worked closely with leadership to outline
a specific scope of prac ce to meet the needs of Hillcrest pa ents
and caregivers. They carried a pager, rounded in all areas of the
hospital, supported the staff as needed, and assigned admi ed
pa ents to available beds. The night shi APCCs also obtained
supplies from the storeroom, retrieved pa ent meals, and were a
resource for many new nurses assigned to work night shi .
As Hillcrest grew, it became clear that the APCC role needed to be
expanded and aligned with the Cleveland Clinic Enterprise, thus
the APCC tle was changed to Nursing Opera ons Manager
(NOM). As a NOM, the administra ve, suppor ve role became
more visible to staff and had increased involvement in nursing
educa on. The number of NOMs soon grew from three night shi
nurses to thirteen, and are now available for Hillcrest caregivers on
most nights and throughout the en re weekend.
Did You Know—NICHE
Lynn Szoka, MSN, RN, G‐CNS‐BC
Nurses Improving Care for Health system Elders (NICHE) is an
interna onal program designed to help improve the care of older
adults. NICHE’s goal is to “achieve systema c nursing change that
will benefit the care of older adults in all healthcare se ngs.” As a
newly designated NICHE hospital, about 65% of Hillcrest pa ents
are over the age of 65 and will benefit from the principles and
strategies supported by NICHE.
Did you know that, in pa ents over 65, coronary event pain can
present differently, 30% are readmi ed within 90 days, and
medica ons have unique prescribing protocols? These are just a
few ques ons that might present when taking care of older adults.
A hospital‐wide survey is underway to assess Hillcrest caregiver
knowledge of geriatric syndromes and opportuni es for
improvement in caring for elderly pa ents. Upon comple on, our
Geriatric Resource Nurses (GRN), specialized in caring for geriatric
pa ents, will share the results of the survey with each unit.
Magnet® and Excellence in Nursing
By Chris ne O’Brien, RN. IBCLC
Nursing educa on has long u lized simula on, including models of
anatomic parts and computer‐based learning programs, to teach
principles and skills of nursing care. Nancy DeWalt, BSN, RN, PCCN
discovered a new approach to use simula on to help educate
pa ents about fall risks in their home. The idea to use simula on
to help reduce falls emanated from a desire to help her husband
who “recently had two strokes, fell several mes at home, and
experienced gait stability problems.” Nancy con nues, “With these
ideas in mind, I began an extensive literature search to learn about
risk factors in the home and discovered there was a huge gap in fall
educa on at hospital discharge.”
A research team of eight was formed, known as the Fall Research
Simula on Team (FRST), charged with re‐examining the origin and
frequency of pa ent falls, especially among the elderly. Research
team members Nancy DeWalt, BSN, RN, PCCN, Sue Sturges, MSN,
RN, CNS, NE‐BC, Ken Stahorsky, MBA, RN, Laura Drobnich Sulak,
MS, BSN, RN, Tonya Rutherford‐Hemming, EdD, RN, ANP‐BC, CHSE,
Lynn Szczepinski, BSN, RN, PCCN, Tyan Clarke, MHA, MSN, RN,
PCCN, and Randy Rhodes, BSN, RN realized that the principles of
hands‐on learning using simula on could be u lized to encourage
pa ents and families to examine their home environment with a
cri cal eye toward recognizing fall hazards.
Ins tu onal Review Board (IRB) and Nursing Research Fund (NuRF)
submissions were approved for a minimal risk study to randomize
pa ents to an interven on group using a permuted‐block
randomiza on scheme. A simula on room was created using one
of the sleep lab rooms and pa ent recruitment began in June,
2015. Instead of focusing on how caregivers can prevent pa ent
falls, this unique study applied the Magnet®
component of “New
Knowledge” to foster pa ent autonomy and provide educa on
aimed at helping pa ents make changes in their home .
The study randomizes pa ents to receive educa on from a wri en
handout or simula on room whereby pa ents can visually inspect
fall hazards common in a bedroom or bathroom. The group
theorized that pa ents would internalize and recall informa on
be er by doing (simula on) rather than seeing (handout). For
those who receive simula on educa on, pa ents are encouraged
to make applica on in their own home environment.
According to Nancy, “The greatest bonus has been that pa ents
are able to see risks first‐hand and iden fy things in their own
home that they simply ignored. Seeing what needs to be done for a
safer environment seems to stay with pa ents in the simula on
group.” Pa ents receive phone calls one week, three months, and
six months post‐discharge to inquire about falls and changes made.
Preliminary findings reveal that recall and reten on have improved
and falls have decreased as a result of simula on versus handout
educa on. Pa ents comment that visualiza on made them realize
how many things they ignored or overlooked in their own homes.
“At this point,” Nancy said, “we are below the na onal average for
repeat falls.”
Editorial Board
Sue Collier, DNP, RN, NEA‐BC Tina DiFiore, APRN, MSN, RN, NNP‐BC
Nancy DeWalt, BSN, RN, PCCN Chris ne O’Brien, RN, IBCLC
Juliann Petrucci, MEd, BSN, RN Ken Stahorsky, MBA, RN
Toni Zito, MSN, RN, CPAN