22 MAGNET EDITION | 2018 | www.advanceweb.com to fostering an environment incorporating evi- dence-based practice and innovation and cel- ebrates our growing professional practice and clinical expertise. In 2017, our leadership team recognized that opioids are among the most effective treatments for acute pain, but can cause dependency, addiction, and death. We assembled a focus team including an ED physician champion and our pharmacy partners. Our aim was to adopt evidence-based ordering practices to avoid con- tributing to the opioid crisis. In light of the con- cerning overuse of hydromorphone, a focus on evidence-based prescribing of morphine over hydromorphone would lead to more judicious use of this potent opioid. Once the plan was formulated, the leadership team rolled the plan with education to all nursing staff across all emergency departments. This initiative led to decreased hydromorphone use from 11.7 orders/100 patients/month to 2.2 orders/100 patients/month, an 81 percent absolute reduc- tion in usage. Our results also demonstrated a 20.9 percent decrease in overall opioid prescrib- ing. In recognition of the work in our emergency departments, Our Health System awarded in 2018 the IAM’s Quality Merit Citation for the team’s great work. With our application for Trauma desig- nation in 2017, our leadership team jumped full force into action utilizing each member’s expertise in developing a plan for education of the staff, equipment procurement, and pol- icy and procedure implementation. With our successful trauma review in 2018, over 90 per- cent of our adult and pediatric nurses received Trauma Nurse Core Curriculum (TNCC) with additional training opened to both off-site ED nurses. Our team continues to ensure expert care for all levels and types of trauma at every emergency department with scheduled mock codes and mock trauma codes for adult, pedi- atric, and obstetric patients. Additional mock codes, equipment training, Stop the Bleed, and TNCC classes are scheduled for this year with an emphasis on off-site ED trauma training to ensure excellent trauma care for our patients throughout our emergency departments. With the ever-increasing violence in our communities, our leadership team continues to focus on workplace violence (WPV) and keeping our patients and staff safe. Initiatives have included increased reporting. At present, we are participating in a system-wide pilot to facilitate violence reporting. This pilot was ini- tiated by our team, who kept reporting to our WPV Committee that our departments were placing safety reports as patient events and not just staff events. In an effort to better reflect the incidences of violence and strategize plans, this pilot will look to capture more accurate num- bers and types of incidences. Our team also facilitated the use of the evidence-based tool for agitation to flag patients in the ED with the potential for violence as an inpatient. The flag information is added to our ISHAPED hand- off report to ensure the next shift and inpatient receiving nurses utilize safety plans and tactics for safety. We provide mandatory paid time for Crisis Prevention Intervention (CPI) training for all staff across our emergency departments. Our team promotes a strong safety culture across our EDs as evidenced by increased reporting and high scores for the Safety Survey in our departments exceeding emergency department benchmarks. The strength of our team’s expertise is mir- rored in the many accomplishments of our nursing staff. In 2017, one of our nurses received the Clinical Expertise Award from the Virginia ENA. One of our clinical directors received the Emergency Department Manager of the Year as a National ENA Award, and a second direc- tor the Clinical Management Award for our Health System. One of the teams presented posters at the ENA National Conference in St. Louis last year and has been invited to present at the Virginia ENA Conference this fall. This year we have cel- ebrated one of our nurses for VNA’s 40 under 40 for professional practice and leadership and two of our leaders for Loudoun County’s 40 under 40 leadership awards. At the hospital and system levels, our lead- ership team and ED nurses have been selected for Transformational Leadership at the hos- pital and system level, New Knowledge and Innovation, and Preceptor for our hospital. We share in each other’s expertise as we promote positivity, forward thinking and growth. Our team looks to remove silos, shift paradigms, and share in the clinical expertise and profes- sional development of our nursing staff and profession. Submitted by Kim Klein Team Members: April Brown, DNP, NE-BC, RN-BC, Senior Director Emergency Services & Trauma AlisonSmolsky,MSN,RN,NE-BC,Director Adult Emergency Department Sarah Stinson, BSN, RN, CPEN, Clinical Director Pediatric Emergency Department Kim Klein, BSN RN CEN CPEN, Clinical Director Ashburn HealthPlex ED Eileen Bowie, BSN, RN, Clinical Director Cornwall ED Stephanie Boese, MSN, RN, CCRN, Trauma Services Manager Lorrie St. Laurent, RN, MSA, BSN, CEN, CCRN, TCRN, Clinical Nurse Educator Adult Elyssa Wood, PhD, MPH, RN, CPEN, Clinical Nurse Educator Pediatric Jordan Tyczka, MSN, RN, CEN, Clinical Nurse Educator Trauma Services Kristelle Toone, MSN, RN, CCRN, Clinical Mentor Yasmin Samahon, MSN, RN, Clinical Mentor BEST NURSING TEAM | MAGNET EDITION The strength of our team’s expertise is mirrored in the many accomplishments of our nursing staff. In 2017, one of our nurses received the Clinical Expertise Award from the Virginia ENA. One of our clinical directors received the Emergency Department Manager of the Year as a National ENA Award, and a second director the Clinical Management Award for our Health System.