SE - Structural Empowerment

Exemplary Exemplar

SE5EO-Commitment to Professional Development:  Describe and demonstrate the effectiveness of two (2) educational programs provided in SE5.

JCMC Ongoing Commitment to Develop and Provide Continuing Educational Programs

Background and Purpose

Rita Smith DNP, RN, NEA-C, CNO and Educational Center for Professional Development are fully committed to providing ongoing continuing education of nursing staff. In early 2013 the need to increase the number of CNE activities was identified as a priority.  

2013 Goals:

  • Increase number of activities with CNE contact hours provided
  • Increase number of RNs participating with CNE activities

Methods and Approach:

In 2013, a change in departmental structure occurred. Previously, clinical educators for specialty areas such as critical care, preoperative, etc. worked under the unit Director or Manager. Currently all clinical educators report directly to the Director of Nursing Education. This allows for a shared mental model and collective goals for the nursing education department. All nurse educators share in teaching responsibilities and co-teach to reach a larger number of staff. This new team has become very adept at developing curriculum and finding teaching opportunities.

Nurse Educators


Specialty Unit

Nicole Sardinas MSN, RN, CCRN


Chaya Lidor MSN, RN, CNL

Medical Surgical

Ebony Samuel MSN, RN

Medical Surgical

Michelle Morales MSN, RN

Maternal Child

Marc Monteith  MSN, APRN,CCRN

Critical Care

Lorraine Esminger MSN, RN


Nancy Rodriguez BSN, RN, CDE

Diebetic Educator

Annette Morales BSN, RN, CEN

Emergency Department

Michelle Dickerson MSN, RN-C



Measurements & Outcomes:

In 2013, 91 continuing nursing education activities were provided to nursing staff at JCMC (see attached Annual Continuing Education Summary).  These offerings more than doubled from 2012. Please refer to the data below for pre and post intervention data.

* please note these educational offerings do not include Registered Nurse Orientation, Competency Day, in-services, and other unit-based activities

Analysis of Data

Effectiveness of fall Prevention Education

Background and Purpose

Falls prevention is a main priority for JCMC. As part of the patients’ plan of care nurses frequently implement many strategies to prevent falls and fall injuries. In 2012, the combined rate of falls for the medical surgical and critical care units was 3.41. The goal for 2013 was to achieve and internal benchmark of 3.23 (5% reduction from baseline). An opportunity for further education was identified when data for the first quarter revealed overall fall rates averaging 3.57. In addition to the comprehensive falls program already established, Peggy Petrucelli RN, BSN, Wounds/Falls manager offered two additional continuing education courses with 90 minutes dedicated to influences related to falls (please refer to Activity outline form). This course was titled “Indentifying skin breakdown & understanding influences relating to falls (please refer to attached flyer). The purpose of the falls prevention section of the course was to provide evidence based falls information to improve JCMC patient outcomes and influence clinical practice


  • Reduce In-patient fall rate below JCMC benchmark of 3.23


Methods/ Approach:

Peggy Petrucelli BSN, RN, WOCN Wound and Fall Prevention Manager observed inconsistent documentation on the John Hopkins fall scale assessment throughout the patients stay. A 90 minute lecture and slide presentation was developed on how to conduct an appropriate falls assessment starting from triage in the ED and throughout the patients hospital stay. Peggy also stressed the importance of gathering the appropriate score and how to apply the appropriate falls protocol for falls prevention. She also introduced how data is collected and monitored once a fall occurs to prevent future occurrences.


3/21/13            Education provided to thirty nurses from the medical surgical and critical care units. Ongoing unit based education was provided to nursing staff as needed to reinforce lessons learned.

5/21/13            Second educational session offered, 30 RNs participated

Measurement and Outcomes:

The education provided during the course, increased awareness among the nursing staff enhancing their assessment of patients who are at high risk for falls. In June the overall fall rates dropped to 2.35. This change was sustained and fall rates remained below the established benchmark of 3.23. The end of year average for fall rates was 2.83. Please refer to the table below for pre and post intervention fall rates.

Effectiveness of Patient Centered Education Course
Background and Purpose

The purpose of this continuing education course was to enhance health care providers’ competency in delivering patient and family centered health education to improve outcomes and prevent readmissions. 


  • Design and implement teach back questions and zones for CHF, AMI, CABG, COPD, PNEU, DM.
  • Decrease AMI 30 day readmission rates to achieve year to date target of 13.87
  • Decrease CHF 30 day readmission rates to achieve year to date target of 17.77
  • Decrease Pneumonia 30 day readmission rates to achieve year to date target of 11.03


  • A total of 299 nurses participated in this activity
  • Course planners and presenters were:



Ingrid Cardenas BSN, RN

Nurse Manager - Relay Care Call Center

Mabel LaForgia MSN, RN, CNL, CCRN

Director of Nursing Research and EBP

Nicole Sardinas MSN, RN, CCRN

Director of Nursing Education

Chaya Lidor MSN, RN, CNL

Nurse Educator – Medical Surgical

Ebony Samuel MSN, RN

Nurse Educator – Medical Surgical

Michelle Morales MSN, RN-C

Nurse Educator – Maternal Child

Marc Monteith  MSN, APRN, CCRN

Nurse Educator – Critical Care

Lorraine Esminger MSN, RN

Nurse Educator – Peri-operative

Michelle Dickerson MSN, RN

Nurse Educator – Neonatal ICU

Peggy Petrucelli BSN, RN

Nurse Manager – Wounds and Fall Prevention

Claudia Garzon-Rivera MSN, RN CNL, CCRN

Nursing Director of Clinical Excellence


Methods and Approach:

As part of the strategic plan for Patient Safety & Clinical Quality Committee, specific tactics were to develop and implement evidence based teach back tools for COPD, CABG, AMI, and to reinforce patient education materials usage. Ingrid Cardenas BSN, RN and Nicole Sardinas MSN, RN who were assigned the tactics decided to combine efforts for both tactics to best educate staff on best practices related to patient education.  They assembled a group of Nurse Educators and Directors to meet, brainstorm, and highlight best practices and resources currently provided.  They then agreed upon a curriculum, and each member created a portion to be combined into one presentation. (Please refer to course outline).  Administrative approval was obtained by Rita Smith CNO to create a mandatory 4-hour course for nurses employed in target areas who served a large population of patients with the selected diagnosis. The course was also open for enrollment to any nurse interested in attending.  This was also discussed with all nursing leaders and directors who fully supported the education plan. Courses were arranged on all shifts (see sample flyer attached) with a total of 32 classes given and 299 nurse learners (1094.34 contact hours provided).  

 The course objectives included:

  1. Describing the teach-back methodology for patient education
  2. Illustrating the process of using web-based learning for patient education
  3. Reviewing various evidence-based educational resources for patient education
  4. Demonstrating teach-back methodology for: AMI, CABG, COPD, PNU, DM, & Falls

2013 Timeline:


Readmission rates and initial strategies examined.  Identified gap in patient education tools for CHF, AMI, CABG, COPD, PNEU, DM. Researched literacy levels, teach back methods, used evidence based research to develop teach back questions and zones for each diagnosis.


Teach back questions and zones developed by Ingrid Cardenas Nurse Manager (See attached zones and teachback questions)


Meeting with various department mangers (such as respiratory, CT surgery, Case Management, etc.) to review newly established teach back questions/zones


Presented and received approval for questions/zones at Professional Practice Council and Quality and Safety Council


Meeting with Nicole Sardinas-Director of Nursing Education to review teach back questions/zones and discuss implementation plan and educators’ involvement


Patient Centered Education-Curriculum Planning Meeting took place
Curriculum Planning Group submitted individual power point slides.  Compilation was created

September    Patient Centered Education courses offered to targeted groups. Education courses maintained ongoing until targeted number of nurses attend course


Measurement and Outcomes:

Analysis of Data

The patient centered education course and the tools developed successfully standardized the process for patient teaching on all patient care units. The increase awareness and knowledge gained from this continuing education program assisted in effectively reducing readmissions in addition to the comprehensive readmission management program already in place at JCMC. As of November 2013, all year to date targets were met.