TL - Transformational Leadership

TL2: Describe and demonstrate how nurses at every level-CNO, nurse administrators, and direct-care nurses-advocate for resources, including fiscal and technology resources, to support unit/division goals.


The following information was missing


  • Verifying evidence for advocacy of fiscal and technology resources that were described


  • Verifying evidence for advocacy of fiscal resources
  • Description and verifying evidence for advocacy of technology resources

-Direct Care Nurse:

  • Description and verifying evidence for advocacy of technology resources


  • Required evidence provided for CNO narrative
  • New Description and verifying evidence provided for Nurse Manager and Direct Care Nurse.

Please review (Appendix TL2-A,) for e-mails to Rita smith re: progress of EMMI

Please review (Appendix TL2-B and C ) for Master Subscription Agreement (first and sign-off page included) and Addendum from EMMI

Please review (Appendix TL2-D ) for instructions on the use of EMMI

Please review (Appendix TL2-E ) for screen shot of EMMI

Please review (Appendix TL2-F) for Dashboard for usage of EMMI

Two new examples of a nurse manager and a staff nurse advocating for resources:

Please note this is a new example of a nurse manager advocating for resources

The Observation Unit, located on 5 East, originally constituted ten (10) beds and was originally initiated in November of 2011. The patient population that this unit serviced was primarily those patients needing Telemetry. The nurse manager in charge of that unit, Marilyn Sarnatora RN, BSN who also manages the Telemetry unit, quickly realized that ten (10) beds was insufficient to meet the needs of the patient population. She determined that four (4) additional beds were needed. In order to obtain the additional beds, it was necessary for Ms. Sarnatora to move the unit to a 14 bed unit on the corresponding side of the hallway. This unit, however, had been a regular medical/surgical unit and did not contain any monitoring equipment, so it became necessary to purchase this equipment.

She initially met with Rita Smith DNP, RN, NEA-BC, Chief Nursing Officer in order to discuss her plan for the Observation Unit. Ms. Sarnatora’s plan did not involve additional staffing, but did involve a capital outlay of $81,000.00. This transition entailed some coordination between disciplines in order to accomplish, for example, Purchasing Department, Biomed Department and Facilities. Ms. Smith and Ms. Sarnatora appealed to the Finance Department for funding for this project. Ms. Sarnatora then contacted Ed Hvitfelt, the Director of Purchasing, in order to discuss her plan and identify a vendor for the project. Since the hospital had an existing contract with Nihon-Koden, they became the vendor of choice. Mr. Hvitfelt reached out to representatives of Nihon-Koden to arrange for a site visit. Mr. Hvitfelt, Ms. Sarnatora and two (2) company representatives had an initial meeting and toured the prospective unit. During this meeting the following issues were discussed:

  • Type of equipment needed
  • Facility capability
  • Review of the updated transmitter
  • Overall cost of equipment and installation
  • Educational support from the company

Quotations were provided from the company, please review the quotations in (Appendix TL2-G ) and capital paperwork was generated and a Purchase Order, please review purchase order ( Appendix TL2-H ) was provided to the company on September of 2012. In the interim period, the Biomed department and representatives from Nihon-Koden performed an in-depth inspection of the wiring to insure it was up to standard coding regulations, please review report in (Appendix TL2-I). Once the equipment was ordered, they company initiated a “Kick-off” Conference Call meeting, please review e-mail regarding meeting in (Appendix TL2-J ). An agenda and an installation Time-Line was established with a Go-Live date of 0/5/13, please review agenda and timeline in (Appendix TL2-K and TL2-L ). It required several months from the time of purchase of the equipment until the time of installation. Once all the monitoring units were installed, Ms. Sarnatora arranged for in-services for all staff on the unit. A nurse was dispatched from Nihon- Koden to work with our nursing staff and insure that competencies and a skills lab on equipment were performed, please review sample competency (Appendix TL2-M ), skills lab and sign-in sheets in (Appendix TL2-N ).

Once the education was completed the patients were moved by the nursing staff with the assistance of the Facilities Department. Thanks to the expertise and under the close guidance of Ms. Sarnatora, this was a seamless transition.

Please note this is a new example of a staff nurse advocating for resources

Vernacare provides a total solution to human waste management in healthcare. It creates a cleaner, safer healthcare environment and focuses on infection control, environmental performance and cost savings. Vernacare medical pulp is the core product that the system utilizes. It provides a range of products which include bedpans, urinals, wash basins and emesis basins. The system includes a macerator. The macerator is an automatic anti-bacterial cleaning process that avoids cross-contamination and emits a mild fragrance.

Chris Amato BSN, RN, CEN, while working as a staff nurse in the Emergency Department, became interested in this process in the Fall of 2011. Her objectives were to:

  • Provide a hygienic, systematic methodology for the elimination of waste
  • Improve the environment via a reduction of plastic waste
  • Provide a cost savings for the hospital

Ms. Amato collaborated with Christine Wade MSN, RN, CEN, Nurse Manager of the Emergency Department to investigate the process. They contacted the Vernacare representative and he suggested that they do a site visit to an area hospital. They visited the hospital and spoke to staff personnel about the usefulness and convenience of the product. They immediately partnered with Ed Hvitfelt, Director of Purchasing, in order to begin an evaluation process in our Emergency Department.

Chris Amato presented this product to the Value Analysis Committee on March 1, 2012, please review meeting minutes (Appendix TL2-O ). It was determined that Bill Cook, Director of Facilities, will arrange for the instillation of Macerators. Vernacare agreed to a “no charge” evaluation of the product whereby they would provide the supplies to be utilized and the installation of two (2) macerators, please review “no charge” PO in (Appendix TL2-P ). The installation occurred in August, 2012; please review meeting minutes May, June and August for documentation prior to installation (Appendix TL2-Q ). The Emergency Department was very satisfied with the use of this product and all the evaluations proved to be positive, please review September meeting minutes (Appendix TL2-R ). Chris Amato began working with the Company Representative in order to create a Return on Investment (ROI), please review meeting minutes and ROI (Appendix TL2-S ). Please review table below for projected cost-savings.

Current Usage of Plastic product in the ED

Wastestream reduction can result in an additional annual savings of $4,671.00 bringing up the total savings to $24,166.58. The system was purchased following the evaluation, please review sale PO for macerators (Appendix TL2-T ). Please review the timeline below:

Timeline for Purchase of Vernacare

Timeline for Purchase of Vernacare