Dana-Farber Cancer Institute Nursing and Patient Care Services (NPCS) Annual Report 2018

NURSING AND PATIENT CARE SERVICES 2018 ANNUAL REPORT

Nursing and Dear Colleagues, Patient Care Services 2018 Annual Report I am pleased to share with you the 2018 Nursing Contents and Patient Care Services (NPCS) Annual Report, 2-5 which highlights major Transformational Leadership accomplishments of our department and progress 6-9 toward achieving goals Structural set out in the NPCS Empowerment Strategic Plan. It has been a very productive year! On Aug. 1, we achieved a departmental 10-15 milestone with the submission of the application Exemplary for our fourth designation as a Magnet hospital. Professional Practice The document demonstrates Dana-Farber’s commitment to clinical excellence and nursing 16-19 practice. One example is our performance above New Knowledge, Innovations, the national benchmark on patient engagement, and Improvements which demonstrates how the components of our Professional Practice Model enable us to 20-23 consistently meet patient needs. Empirical Outcomes This year, NPCS staff disseminated work nationally and internationally and published 24-33 in several peer-reviewed journals. We hosted Accomplishments three Nursing Symposia, attracting nurses from around New England, and established This annual report reflects nursing and patient care continuing education sessions for Dana-Farber services activities through October 2018. staff on Friday mornings. Our nurses developed educational modules to increase nursing skills in assessment and management of patients receiving immunotherapies, and in educating patients about these novel treatments. We have also steadily increased nursing specialty

2017–19 NPCS Strategic Plan Personalize the Experience Advance and Transform Build the Team and for Every Patient the Practice of Nursing Develop Leaders • Continue to improve and customize the • Establish an ongoing peer review process to • Create programs and incentivize nurse patient experience through the use of advance the practice of nursing across DFCI. mentorship and preceptorship. new technologies. • Advance and deepen nursing competencies • Become known as the center that recruits, • Lead/support development of an to ensure continuous improvement of the trains, and develops the best oncology nurses. interdisciplinary education strategy high-quality care delivered. for new treatment modalities. • Formalize career paths to advance professional • Create formal process to share, acknowledge, engagement and lifelong learning. • Implement symptom management and celebrate our work both internally pathways with defined measures of success. and externally. • Continue to build a culture of healthy clinicians/staff in an inclusive work • Conduct original research in area of quality of environment that supports diversity. life and quality of care for patients and families. • Secure philanthropic support for NPCS programs. • Foster scholarship in evidence-based practice. certification rates across the department. I am very proud of our efforts to create a more Nurses and other Patient Care Services staff inclusive environment within NPCS through our acknowledgement and recognition programs. participated in the first Dana-Farber Digital Health Symposium, which spawned a year of learning about In 2019, we will partner with the Boston academic new technologies to solve problems, reduce the community to train newly licensed nurses from administrative burden for clinicians, and improve diverse backgrounds, as well as specific efforts to the patient experience. These learning efforts have support career growth and development among our moved us toward testing a few digital solutions in the clinic assistants. coming year. I look forward to the year ahead as we continue to We are expanding our footprint across Massachusetts, strive for excellence and build a more inclusive practice which will allow us to bring Dana-Farber care to more environment where all feel a sense of belonging within patients and families. In 2020, we will open a Merrimack Nursing and Patient Care Services. Valley site as well as the Chestnut Hill and Foxborough sites. Internationally, we have formed relationships with Warmly, hospitals in China and Brazil to share our knowledge and expertise more widely. Anne H. Gross, PhD, RN, NEA-BC, FAAN Senior Vice President for Patient Care Services We refreshed the NPCS preceptor program and Chief Nursing Officer to ensure that new employees are oriented by skilled peers. At the same time, we increased staff engagement in peer feedback through educational seminars, role modeling, and online learning.

TRANSFORMATIONAL LEADERSHIP NPCS Leadership: Promotions and New Hires In 2018, the NPCS team continued to grow under the Cindy Arcieri, MS, APRN, OCN, was hired as director leadership of Senior Vice President for Patient Care Services of clinical operations for Dana-Farber/New Hampshire and Chief Nursing Officer Anne H. Gross, PhD, RN, NEA- Oncology-Hematology and Larissa McLaughlin, BSN, RN, BC, FAAN. Several promotions occurred throughout the OCN, also joined as a clinical nurse coordinator for that year, as well as key hires into new or existing positions. site. Cindy Maio, BSN, RN, OCN, was hired as a clinical nurse coordinator at Dana-Farber Community Cancer Care Angela Creta, DNP, RN-BC, CNL, NE-BC, was promoted (DFCCC) Lawrence and Diana Spang, BSN, RN, OCN, was to executive director of the Center for Clinical and Professional hired for the same role at DFCCC Methuen. Development (CCPD). Creta joined Dana-Farber in 2017 and most recently led the Institute in its ANCC Magnet Deborah Toffler, MSW, LCSW, was promoted to senior redesignation document submission. In addition to providing director, Patient Care Services. Toffler joined Dana-Farber strategic oversight of professional development, orientation, in 2006 and has served in various roles in the department Nursing Quality, and Magnet, Creta now leads the nurse of Social Work and NPCS. Toffler now oversees Interpreter residency program, international programs, the integrative Services and Spiritual Care in addition to Volunteer nursing program, and patient and family education. Creta also Services, the Eleanor and Maxwell Blum Patient and Family became an ANCC Magnet appraiser in 2018 after completing Resource Center, the Ruth and Carl J. Shapiro Center for 18 months of training. Patients and Families, and other services and programs that provide supportive resources for Dana-Farber patients Katie Magni, MSN, RN, OCN, was promoted to nurse and their families. director of Dana-Farber/Brigham and Women’s Cancer Center at Milford Regional Medical Center. Laura Ma, BSN, RN, OCN, was promoted to the new role of director of nursing for outpatient solid tumor programs. Jessica Driscoll, DNP, RN, joined Ma in a newly created position of director of nursing for hematologic malignancies. Lisa Streeter, MSN, RN, joined Dana-Farber as program manager for Nursing Quality. Renee Abdella, BSN, RN, OCN, BMTC, was hired as nurse director of the DFCI Inpatient Hospital, and Kellie Olsen, MSN, RN, NP, OCN, BMTCN, joined as clinical specialist for the Inpatient Hospital. Megan Corbett, MSN, RN-BC, OCN, and Samantha Morrison-Ma, MSN, ANP-BC, WHNP-BC, were also hired as clinical specialists, with Corbett supporting network sites and Morrison-Ma working in the CCPD. Former infusion nurse Cari Ryding, MSN, RN, OCN, returned to Dana-Farber as director of Nursing and Clinical Services on the ninth floor of the Yawkey Center for Cancer Care. Katie Magni 2 NURSING and PATIENT CARE SERVICES: TRANSFORMATIONAL LEADERSHIP

Deborah Toffler Resource Integration Initiative Links Patients with Supportive Resources To ease the experience of cancer treatment for patients and their loved ones, Dana-Farber offers financial assistance, spiritual care, interpreter services, reiki, and much more. Staff in the Department of Patient Care Services are engaged in a Resource Integration (RI) initiative, led by DeborahToffler, MSW, LCSW, senior director, Patient Care Services, and Patricia Stahl, MEd, senior manager, Volunteer Services and Programs, to more effectively connect patients and families with available resources. Generous support from Charles Roussel through the Roussel Family Fund made it possible to establish three pilot projects during the past year that support the RI initiative. Each initiative addresses the RI mission from a different angle. In September 2018, the team launched a pilot “Resource Center Pop-Up” that integrates volunteers and resources directly into treatment centers. One day a week for two months, volunteers brought educational literature and disease-specific information to Yawkey 7, where patients with multiple myeloma and gastrointestinal cancers are treated. Here, volunteers spend time rounding, promoting resources, and answering questions. Volunteers also help patients register for Partners Patient Gateway to access their scans, test results, and other appointment- or treatment-related information. The goal of this pilot is to sustain this type of service permanently on all treatment center floors at Dana-Farber. In addition, the team has been meeting with nurse and physician leaders, program nurses, administrative staff, and patients and caregivers to create a referral field in Epic for supportive resources. The purpose of the referral is to connect patients and family members with resources to ease the patient experience and streamline the process for referring physicians. Finally, the project team has been working to improve Dana-Farber’s patient-facing digital presence to make it easier for patients to locate and identify available resources. Guiding these efforts was the creation of a “common core,” or project vision, that involved taking a comprehensive inventory of existing resources and partnering with stakeholders, including the Adult Patient and Family Advisory Council, to develop consistent language to describe them. www.dana-farber.org/nursing 3

Blum Resource Center and Volunteer Programs The Ruth and Carl J. Shapiro Center for Patients and Families and the Eleanor and Maxwell Blum Patient and Family Resource Center are located on the first floor of the Yawkey Center for Cancer Care and offer patients and families a comfortable environment to learn about supportive services and educational and financial resources at Dana-Farber and in the community. Here, they have access to caring and compassionate volunteers who welcome patients and help answer questions. Both centers are led by Patricia Stahl, MEd, senior manager of Volunteer Services and Programs. In 2018, the Volunteer Services and Programs team welcomed 140 new volunteers who all have a passion for helping others and giving back to Dana-Farber. New volunteers complete a comprehensive training that includes Dana-Farber’s philosophy of “treating the whole patient.” To best serve our patients, efforts were Deborah and Allan Osborne made during the past year to recruit and train volunteers who are bilingual in Spanish, Arabic, and Chinese (Mandarin). “We must increase access to Volunteers Honored for culturally diverse and bilingual volunteers who can help Accomplishments and Contributions communicate the variety of resources and services To honor more than 500 volunteers who donated offered,” says Stahl. “Increasing cultural and language their time to Dana-Farber, Volunteer Services hosted its diversity among volunteers expands perspective and annual Volunteer Recognition Dinner in June. Anne H. encourages an increasingly inclusive environment for all”. Gross, PhD, RN, NEA-BC, FAAN, senior vice president Bilingual volunteers provide guidance and support to for Patient Care Services and chief nursing officer, and staff around programmatic design and implementation, Deborah Toffler, MSW, LCSW, senior director, Patient creating more opportunities to develop ethnically and Care Services, gave keynote speeches that highlighted culturally diverse programming. the dedication and compassion of volunteers and In September, Maritza Nassif, MEd, program thanked them for their contributions. coordinator, Patient and Family Resources and a In closing the recognition event, Volunteer Services member of the Blum Resource Center Spanish- presented Allan and Deborah Osborne with the Sidney Speaking Advisory Committee, hosted the second Farber Volunteer of the Year Award for their devotion to annual Hispanic Heritage Program, which included volunteering. The Osbornes spent their professional lives traditional Hispanic food, music, and an art activity. working as educators and have been involved in a long Program participation increased 30 percent from 2017, list of projects and activities at the Institute, especially the attracting more than 50 patients, family members, One-to-One Program, Blum Resource Center advisory volunteers, and staff who connected over their committee, and as members of The Friends of Dana-Farber shared Spanish heritage. Through these efforts, and the Adult Patient and Family Advisory Council. as well as developing brochures and pamphlets in Volunteers Olivia Bogan, Erin Curley, and Gloria Silver, other languages, the Blum Resource Center and were presented with Above and Beyond Awards. All awards Shapiro Center saw a 50 percent increase in are made possible through the continued generosity of the Spanish-speaking patients. Charles and Rowena Simberg Foundation. 4 NURSING and PATIENT CARE SERVICES: TRANSFORMATIONAL LEADERSHIP

International Interpreter Ambassador Program Launches Dana-Farber provides medical interpreters to patients with providers and the International Patient Center. and families who speak a language other than English. To date, the Interpreter Ambassador Program has Dana-Farber’s Interpreter Services program, managed by Nina Scott, CMI, is staffed by trained professionals who supported 51 Arabic- and 44 Chinese-speaking international speak 25 languages, including Arabic, Mandarin, Spanish, patients, totaling 2,225 Dana-Farber patient encounters. Haitian Creole, and Russian, and share some of the many cultures of our patient population. Interpreters are excited about this expanded role and feel they have a unique opportunity to showcase their skills This year, a workgroup that included Dana-Farber (i.e., interpreting, cultural brokering, customer service). Interpreter Services and the Brigham and Women’s They see a great benefit in this program and have stated International Patient Center was tasked with improving the that “patients feel more comfortable asking questions and patient experience for international patients. In response, seeking services because of the trust and comfort built the workgroup piloted the first-ever International Interpreter from this role.” They look forward to continuing the program Ambassador Program. The mission of the program is to with other languages in the future. help international patients navigate the system of care at Dana-Farber/Brigham and Women’s Cancer Center. The Pictured left to right are some of Dana-Farber’s 60 interpreters: pilot is made up of 11 Arabic and six Chinese interpreters Fayrouze Belgacem, Victwar Shenoude, Jane Lee, Majda Benahmida, who serve all Arabic- and Chinese Mandarin-speaking Nane Kouyoumjian, Dennis Cheng, Beth Ng, and Eunice Woo international patients. To support the Ambassador Program, the work group developed a new job description, role competencies and responsibilities, and performance expectations. The six main competencies encompass the spirit of providing medical interpreting, ensuring continuity of care, and addressing the unique needs of the international patient population. Some of the responsibilities include providing a tour of Dana-Farber, including future appointment locations, calling to remind patients of appointments, and connecting international patients Resource Specialists Support Patients, Families Through Cancer Treatment Resource specialists in the Division student work with clinical care teams Hannah Kitzmiller, senior of Patient and Family Programs and to help eligible patients access resource specialist, and her Services work both in the ambulatory critical resources and services. colleagues have been promoting setting and at the DFCI Inpatient Two pharmacy resource specialists awareness of resources available to Hospital. In this role, they help also assist with the high costs of patients through presentations at the income-eligible patients and their treatment-related medication co- new Welcome Center and to new families identify affordable short-term payments. The teams assist patients patient coordinators. Since October accommodations and transportation and family members who qualify 2018, resource specialists have options during treatment, work and have been connected to the offered “office hours” in the Blum with them to apply for foundation Resource Office. To continue to Resource Center for patients and assistance, and provide referrals to meet Dana-Farber’s needs, a satellite family members to get help filling community programs. resource specialist and workforce out applications for foundation development student will be added assistance and to learn about Five resource specialists and a to the team in 2019. other possible resources. Northeastern University cooperative www.dana-farber.org/nursing 5

STRUCTURAL EMPOWERMENT NPCS Honors Staff at Spring Event In May, Dana-Farber recognized several NPCS staff The following staff were recognized during the event: members across the Institute. The Award and Recognition Committee, a subgroup that reports to the Dana-Farber • P resident’s Award for Nursing Excellence to Nancy Nursing Council, was chaired by Donna Flynn, RN, OCN, Grant, RN, OCN, charge/infusion nurse, Dana-Farber program manager for Dana-Farber Community Cancer Care, Cancer Institute at St. Elizabeth’s Medical Center and Fran Leonard, MSN, RN, AOCN, director of nursing and clinical services at Dana-Farber Cancer Institute at • Award for Excellence in Relationship-Based Nursing Care St. Elizabeth’s Medical Center. The committee received to Jeanine McManus, BSN, RN, CPHON, staff nurse, 65 nominations honoring 54 individuals. Jimmy Fund Clinic, and Cameron Sze, BSN, RN, clinical trials nurse  During the celebration, Dana-Farber senior leaders recognized NPCS staff for their efforts. Dorothy Puhy, MBA, • O utstanding Clinic Assistant Award to Amy Ferreira, chief operating officer, thanked staff both in a professional lead clinic assistant, Yawkey 7, Damon Morris, clinic capacity and as the wife of a former patient here. “What assistant, Yawkey 6, and Lindsay Speight, clinic we have been able to build [in the satellites] has been a assistant, Dana-Farber/Brigham and Women’s Cancer tremendous asset to the organization – and to our patients,” Center at Milford Regional Medical Center said Puhy. Anne H. Gross, PhD, RN, NEA-BC, FAAN, senior vice president for Patient Care Services and chief • C ollaborator in Care Award to Janette Danowski Hale, nursing officer, noted that “patients come to us because RPh, BCOP, pharmacist, Dana-Farber/Brigham and of Dana-Farber’s world-renowned reputation, but they Women’s Cancer Center in clinical affiliation with stay here for their care because of all of you,” she said. South Shore Hospital “Your commitment, deep expertise, and caring practices are second to none. You walk the cancer journey with your • C ulture of Care Award for Excellence in Patient patients all the way, no matter where it takes them and Experience to Nane Kouyoumjian, interpreter, and you, and you do it with incredible skill and unwavering Scott Maidment, maintenance manager compassion. Thank you for all you do.” • T homas M. Kloss Nursing Leadership Award to Kathleen Bielagus, BSN, RN, OCN, charge/infusion nurse, Dana-Farber Cancer Institute at St. Elizabeth’s Medical Center 6 NURSING and PATIENT CARE SERVICES: STRUCTURAL EMPOWERMENT

Preceptors Honored for Interpreter Pursues Dream Mentoring New Staff of Becoming a Nurse Dozens of nurses, nurse practitioners, clinical assistants Azza Elsheikh has been working as an Arabic and leadership staff gathered in May for an inaugural event: the annual Preceptor Appreciation Breakfast. The breakfast interpreter at Dana-Farber and other Longwood- recognized preceptors who volunteer to share their expertise, helping orient new employees in NPCS. area hospitals for the past three years. Honored to “Precepting is one of the most important things we do serve as an intermediary in interactions between here, and it is what makes us who we are,” said Anne H. Gross, PhD, RN, NEA-BC, FAAN, senior vice president for nurses and patients, she developed a desire Patient Care Services and chief nursing officer. to switch roles. “Seeing children and adults go About 175 nurses, nurse practitioners, and clinical assistants have served as preceptors in the past 18 months, through cancer treatment, and how crucial a according to Angela Creta, DNP, RN-BC, CNL, NE-BC, executive director of the Center for Clinical and Professional nurse is in their care and comfort, inspired me,” Development (CCPD). says Elsheikh. “I wanted to have that same type Creta and Emma Dann, DNP, RN, OCN, NEA-BC, associate chief nurse for the Dana-Farber network, shared testimonials of connection with patients.” Now, after finishing from staff thanking preceptors who enriched their orientation. prerequisite courses at Bunker Hill Community In addition, Michelle Ranaghan, MSN, RN, OCN, staff nurse on Yawkey 6, and Colleen McLaughlin, BBA, CCPD College, Elsheikh is applying to nursing school. She program coordinator, presented a video they made in which nurses and clinic assistants recognized their preceptors. plans to continue working as an interpreter part- NPCS also launched a preceptor workshop and a preceptor time and is hoping to eventually earn a master’s award that will be presented each fall. Two workshops were held in 2018; additional classes are scheduled for 2019. degree and become an oncology nurse practitioner. The preceptor workshop was proposed by Ranaghan, “It is wonderful to see Azza spread her wings who also co-chairs the Nursing Council, based on a gap analysis she conducted. Ranaghan and Clinical Specialist and set forth to achieve her dream,” says Nina Samantha Morrison-Ma, MSN, ANP-BC, WHNP-BC, say the goal is to standardize the preparation of preceptors. Scott, CMI, manager Another new initiative in 2018 was the development of of Interpreter a preceptor advisory board comprising nurse leaders and clinical nurses. The purpose of the board is “to shape Services. “She has the preceptor program and evaluate the effectiveness of precepting.” made meaningful 2018 Preceptor Breakfast Planning Committee contributions to the patient experience here with the perfect combination of skill, professionalism, warmth, and compassion. Azza will be a terrific nurse.” Azza Elsheikh Elsheikh took part in a Dana-Farber shadow opportunity coordinated through the Center for Clinical and Professional Development. Elsheikh shadowed Alyssa Ywuc, BSN, RN, OCN, an infusion nurse on Yawkey 8, as she went through her regular shift. The example of developing relationships, set by Ywuc and other Dana-Farber nurses, is a big part of Elsheikh’s decision to pursue nursing as a career. So too are the patients she has gotten to know through sessions as their interpreter. One in particular remains on her mind – a woman with cancer that spread throughout her body. “Nurses were invaluable in providing her compassionate care, and that affected her attitude toward her cancer,” says Elsheikh. “She became more resilient and optimistic. She felt safe.” www.dana-farber.org/nursing 7

Documentary Filmmaker Carolyn Jones Headlines Certified Nurses Day In March, clinicians and their colleagues marked Carolyn Jones Certified Nurses Day with a dinner celebration. Flynn, a certified oncology nurse for 20 years, was In addition to acknowledging Dana-Farber’s 25 newly certified recognized for her leadership as program manager of nurses and New England Regional Black Nurses Association Dana-Farber Community Cancer Care (DFCCC), and for awardees Mitzie Cazeau, BSN, RN; Angela Kigathi, BSN, RN; supporting and promoting nursing certification. Among the and Inez Robinson, RN, OCN, the event honored several other highlights mentioned during the evening was DFCCC Methuen special attendees: Certified Nurse of the Year Donna Flynn, nurses achieving 100 percent certification. RN, OCN; documentary filmmaker Carolyn Jones, whose keynote speech focused on her nationally acclaimed book and “I’m proud of the whole team,” said Flynn. “Certification is films on nursing; and Dana-Farber Trustee Amy Zarkin Reiner so important – it helps nurses grow professionally and and her parents, Herb and Susan Zarkin, longtime supporters of reassures patients. I hope next year we have another whole DFCI nursing whose Zarkin Family Staff Support and Renewal practice to celebrate.” Program made this special event possible. “In a field as dynamic as oncology and an institution as cutting-edge as ours, it is imperative that our nursing staff be the best and brightest,” said Anne H. Gross, PhD, RN, NEA- BC, FAAN, senior vice president for Patient Care Services and chief nursing officer. Teaching Mission Extends to High School Students Foundational to its mission as a Middle College (RINIMC), who visited practitioners, research nurses, and Harvard-affiliated teaching hospital, Dana-Farber for a full day. The mission of Senior Vice President for Patient Care Dana-Farber is dedicated to educating RINIMC is to prepare a diverse group Services and Chief Nursing Officer future health care professionals. This is of students to become a highly educated Anne H. Gross, PhD, RN, NEA-BC, exemplified by the Nursing Department’s and professional nursing workforce of FAAN. Each shared their perspectives academic partnership program, which the future. The visit was coordinated by and discussed the unique paths that places dozens of nurse practitioner Colleen McLaughlin, BBA, program led them to careers in nursing and students with clinical preceptors each coordinator of the Center for Clinical and patient care services. Members of the semester. In May 2018, this effort was Professional Development. Patient and Family Advisory Councils extended to 22 high school students also shared their experience of being from Rhode Island Nurses Institute As part of their visit, students patients and caregivers. met with clinic assistants, nurse 8 NURSING and PATIENT CARE SERVICES: STRUCTURAL EMPOWERMENT

Training Initiatives: Nurses Advance and Transform the Practice of Nursing The cancer treatment landscape is rapidly changing. Dana-Farber is at the forefront of discovery and implementation of innovative therapies, with more than 600 therapeutic trials open and accruing patients. Central to Dana-Farber’s mission is continuously educating staff to ensure they are prepared to administer, monitor, and manage the latest protocols. In addition, Dana-Farber has a long-standing mission to mentor, educate, and grow future clinicians. To advance these goals, Nursing and Patient Care Services has implemented educational programs to develop research nurses and support all nurses who care for patients being treated with novel therapies, such as chimeric antigen receptor (CAR) T-cell therapy. Newly Licensed Research Nurse Lauren Spendley and Kathleen McDermott Residency Program form of therapy, a patient’s T cells are removed, re- In 2018, Dana-Farber “graduated” its second cohort from engineered, and reinfused into the patient to fight their the Newly Licensed Research Nurse Residency Program. specific cancer cells. This therapy has a unique toxicity The program continues to foster the successful transition profile that must be managed carefully. of newly licensed, baccalaureate-prepared nurses into the clinical research nurse role. Residents Margaret Carey, BSN, To prepare nurses to care for patients receiving RN, and Danielle Nunziato, BSN, RN, completed a one- CAR T-cell therapy, Kathleen McDermott, BSN, RN, OCN, year residency program that exposed them to working with BMTCN, and Lauren Spendley, MSN, AGNP-BC, AOCN, principal investigators on the protocol development and review worked together to develop a comprehensive competency- process. They also assisted with recruitment, screening, and based education program and collaborated with clinical registration of patients to clinical trials, and provided protocol peers Kecia Boyd, MSN, RN, AOCNS, BMTCN; education to patients, families, and staff. The 2019 residents Susanne Conley, MSN, RN, CPON, AOCNS; and are Sheridan Aspinwall, BSN, RN, and Mark Sawin, BSN, Lauren Sullivan, MSN, RN, AGCNS-BS, OCN, to RN. They entered the program in September 2018 and will provide education that included in-person sessions, practice for six months in infusion and inpatient settings before competency assessments, unit-based job aids, and an beginning the research portion of their learning in March 2019. online curriculum. Research Foundations Course The clinical trials nursing office has expanded the curriculum of the Research Fundamentals course for all nursing staff. Kristen Legor BSN, RN, OCN, JD; Caryn Caparrotta BSN, RN, OCN; Kerry Hennessy MSN, RN, AOCN; Leah Killion, MSN, RN, OCN; Margaret Lance, RN, OCN; and Cameron Sze, BSN, RN, developed the course, which includes overview information on clinical trials, navigation of the Oncology Protocol System, research standards of practice, an explanation of research study team member roles, and a summary of communication workflows. CAR T-cell Therapy Education Initiative Upon completion of several CAR T-cell clinical trials, Dana-Farber/Brigham and Women’s Cancer Center researchers developed a program specific to CAR T-cell therapy in preparation for Food and Drug Administration approval of a commercial CAR T-cell therapy and the anticipated increase in patient volume. In this revolutionary www.dana-farber.org/nursing 9

EXEMPLARY PROFESSIONAL PRACTICE ‘Good to Go’ Initiative Enhances Patient Safety With many chemotherapy treatments, there is a slim specialists, quality and process improvement specialists, margin between a dose that offers a therapeutic effect nurse directors, and pharmacists. The team reviewed and a dose that causes toxicity. Errors in chemotherapy chemotherapy verification processes from several leading treatment pose a serious risk to cancer patients, who are oncology organizations, including the Oncology Nursing often already frail and physically compromised by their Society, the American Society of Clinical Oncology, and disease. Adding to its many other systems to ensure the American Society of Health-System Pharmacists, to patient safety, Dana-Farber piloted and implemented a establish the verification process used by Dana-Farber new worksheet and communication system called “Good to nurses and pharmacists. From this, they developed a Go”to standardize nurse reviews of patient chemotherapy one-page worksheet used by all nurses in their review orders, treatment plan, and clinical status before a of chemotherapy orders. The worksheet includes critical patient is treated. information such as previous dosing, date of signed consent, pre-treatment medications, and other safety concerns, in Led by Nurse Director Katie Magni, MSN, RN, OCN, the addition to background information like regimen, provider Good to Go workgroup included infusion nurses, clinical name, and medical record number. The worksheet guides discussions between nurse and pharmacist to determine Good to Go work group members Melissa Perna, BSN, RN, whether a patient is “good to go” to receive treatment. and Richard Crifasi, PharmD Members of the work group also developed a staff educational video that demonstrates interdisciplinary collaboration and communication. The Good to Go pilot took place in early 2018 on Yawkey 7 and at Dana-Farber Cancer Institute at St. Elizabeth’s Medical Center and was fully rolled out to all Dana-Farber sites during summer 2018. Implementation of standard communication processes between nursing and pharmacy decreased the percentage of pharmacy interventions from 8.8 percent to 2.8 percent. The Good to Go initiative was presented at the annual American Society of Clinical Oncology Quality Symposium in September 2018. Study Evaluates Outcomes of Pancreatic Binder Pilot In 2017, a team of program nurses and nurse evolved to be an evidence-based practice project. practitioners in the Gastrointestinal (GI) Cancer Treatment The 2018 project team brought to the table their Center worked with Patient Education Program Manager Clare Sullivan, BSN, RN, OCN, MPH, and Gabby Spear, expertise, the patient experience, and the best a representative of the Patient and Family Advisory scientific evidence. They designed a three-step teaching Council, to develop and pilot an educational binder intervention led by nurses using the patient binder, for patients. including a binder template that can be customized for each patient. Sections focused on preparing for treatment, After receiving positive feedback from the pilot, the coping during treatment, and accessing ongoing support team consulted colleagues in the Phyllis F. Cantor Center resources. A QR code in the binder links the patient to a for Research in Nursing and Patient Care Services to video tour of the infusion setting. The patient’s treatment explore continuing the project in 2018 using an evidence- schedule, medications, side effects, and support services based practice model. With the expertise of Clinical are some of the elements in the binder that help the Inquiry Specialist Terri Jabaley, PhD, RN, the initial work patient and caregiver. 10 NURSING and PATIENT CARE SERVICES: EXEMPLARY PROFESSIONAL PRACTICE

Through Organization Membership, Nurse Influences Practice Adonica Racicot, BSN, MSPC, RN, University of Colorado and developed the number of palliative care referrals OCN, works as a charge nurse in the an interest in the palliative care needs through education and daily discussions infusion room at Dana-Farber/Brigham of her patients. Racicot attended the with colleagues. and Women’s Cancer Center at Milford American Academy of Hospice and Regional Medical Center and has been a Palliative Medicine/Hospice and Palliative Racicot completed a needs assessment with providers and Adonica Racicot Nurses Association’s nursing staff, developed an educational member of the Oncology Nurses Society spring 2018 conference intervention that incorporated screening and Hospice and Palliative Nurses with Lauren McGovern, and prognostication tools to identify Association (HPNA) for several years. BSN, RN, OCN, who is patients that would benefit from also a clinical nurse and a palliative care intervention, and HPNA was a valuable resource to palliative care champion rounded with clinical nurses to increase Racicot as she completed her master’s at Milford. awareness of the benefits of palliative degree in palliative care nursing at the care referrals. She also used teaching Through her work as sheets created by Dana-Farber’s Patient a charge nurse, Racicot Education Committee, chaired by Clare observed that patients Sullivan, BSN, RN, OCN, MPH, and with advanced cancer highlighted patient education using a were not always being bulletin board in the clinic. Education referred to palliative and coaching, routine discussion about care. She also noticed palliative care, and one-on-one nurse that when there was conversations with patients increased discussion about palliative care referrals from 1.7 to 7.5 palliative care amongst percent between December 2017 and clinician colleagues, palliative care July 2018. Racicot stated that “one referrals increased. To address this gap, important gain from the project was the Racicot initiated a quality improvement ability to empower nurses to introduce project in palliative care as part of her and discuss palliative care options with graduate school capstone project. The their patients.” aim of the project was to increase Co-investigators Jabaley, Nina Grenon, DNP, Patti Rizzo and Terri Jabaley AGCNP-BC, AOCN, and Patti Rizzo, BSN, RN, led the team in designing an IRB-approved study to w w w . da n a - fa r b e r . o r g /n u r s i n g 11 evaluate outcomes of using the binder in a systematic intervention provided by GI program nurses. Several patient and care delivery outcomes are currently being measured. Preliminary data indicate improved patient outcomes when the binder is used in strategic nurse/ patient encounters. Patient feedback on the usability of the binder has been positive and has helped the team improve the intervention. Patients have emphasized that what is most valuable to them is the individual interaction with and support of nurses.

Survivorship Care Plans Optimize Patient Care, Meet Commission of Cancer’s Accreditation Standards Thanks to improved cancer treatments, earlier detection, In recognition of the need for additional interdisciplinary and increasing numbers of people taking advantage of experiences and learning about survivorship, clinical rounds cancer screening, more people than ever are surviving were established as part of the Survivorship Program. In cancer both in the short- and long-term. the monthly clinical rounds meetings, interprofessional Dana-Farber developed its Adult Survivorship Program clinicians in the program discuss individual cases, usually in 2005. Today, under the leadership of Ann Partridge, focusing on specific issues but also addressing more MD, MPH, the program has expanded to include Nurse general cancer survivorship concerns. Processes of Practitioners Nina Grenon, DNP, AGCNP-BC, AOCN; care and standards are addressed in these meetings in Patricia Nutting, MSN, NP; and Tara Roy, MS, NP, as an interdisciplinary manner, and literature and data are well as physician specialists including an internist focused reviewed to inform the survivorship compendium and on cancer survivorship, two onco-cardiologists, two improve how care is provided to cancer survivors. In onco-nephrologists, and two gynecologists. The program addition, Nutting is a member of the interprofessional also includes a fertility preservation team, a sleep specialist, Dana-Farber Patient Education Committee, which makes sexual health clinicians, and services such as smoking- decisions about educational material content, format, and cessation counseling. revisions for all patients, including survivorship patients. The program provides survivorship services to Dana-Farber patients with a focus on optimizing care as they move beyond treatment. The providers created and utilize a regularly updated compendium of guidelines for the major cancer survivor groups, comprising both common and specific disease/treatment aspects of survivorship care that should be addressed with each patient as they transition from active cancer diagnosis and treatment to survivorship. Templates were created by the Survivorship Program and embedded in the medical record to allow clinicians to create survivorship care plans and share them with patients and other providers. In 2014 and again in 2017, the American College of Surgeon’s Commission on Cancer (CoC) accredited Dana-Farber/Brigham and Women’s Cancer Center. The CoC is a multidisciplinary consortium of professional organizations dedicated to improving survival and quality of life for cancer patients. The CoC has specific standards regarding survivorship care, including delivery of survivorship care plans. Organizations are required to deliver survivorship care plans to 50 percent of eligible patients by 2018; the standard articulates the minimum components of the care plan. Dana-Farber set a goal of increasing the percentage of eligible patients who receive a survivorship care plan to achieve the CoC target of 50 percent by the end of calendar year 2018. Tara Roy and Patricia Nutting 12 NURSING and PATIENT CARE SERVICES: EXEMPLARY PROFESSIONAL PRACTICE

Milford Satellite Offers Mindfulness Practices for Patients and Staff Catherine Hulme-Freudenberger Speight, clinic assistant, applied for and received an Integrative Nursing Program practice grant to address this Patients undergoing cancer treatment often experience gap in knowledge and apply evidence-based mindfulness anxiety and stress associated with their diagnoses and practices in the practice environment. treatments. Mindfulness practices have been shown to promote relaxation and decrease distress in oncology patients. Staff attended training sessions about these practices and nurses received continuing nursing education credits for their Nurses and clinic assistants at Dana-Farber/Brigham participation in the sessions. All infusion clinic staff were and Women’s Cancer Center at Milford Regional Medical invited to participate in an anonymous survey four weeks Center reported limited understanding about how to before training sessions began. This provided baseline data incorporate mindful practices into the care of patients and about staff understanding, skills, and confidence in the use how they might align mindfulness practices with the Nursing of mindfulness practices. Department’s Professional Practice Model. Catherine Hulme-Freudenberger, BSN, RN, MS, OCN, and Lindsay A Mindfulness Activity Cart (MAC) was also developed and stored on the unit for patients and families. The MAC includes two iPads with a meditation/mindfulness app, guided meditation and music, headphones, journals, biodots, printed learning materials, and other resources that patients and families can use during their visits. Once trained, staff were encouraged during in-clinic huddles to offer the MAC to all interested patients and families. Staff respondents to the post-survey reported increased calmness, awareness of self, and feelings of relaxation and peacefulness. The project was so well-received that staff asked for regular mindfulness walk-in sessions to address stress. Patient Navigator Helps Reduce No-Show Rates Dana-Farber’s Patient Navigation developed new interventions In evaluating the impact of program in the Division of to reduce no-show rates for these interventions, the Pap Patient and Family Programs and follow-up appointments. In prior Smear Evaluation Center Services helps remove barriers years, Peña was instrumental in experienced a reduction in and improves access to care for reducing the no-show rate from the no-show rate for follow- breast and gynecologic patients. 49 percent to 29 percent but up appointments from Patient Navigators help patients follow-up appointments remained 29 percent to 18 percent understand what to expect at a concern. New efforts included – a significant decline. In their appointments so that they reminder calls six days prior to November, Peña presented can make informed decisions, the appointment, educational the results in Dallas at the arrange for tests or appointments, materials offered in multiple 9th Annual Navigation and determine questions to ask their languages to teach patients Survivorship Conference through care team, and access information about the importance of early the Academy of Oncology Nurse about resources and services. detection for cervical cancer, and Patient Navigators. and an analysis of why patients In 2018, Patient Navigator Nancy were missing appointments (the Peña and the Pap Smear Peña, OPN-CG, and her colleagues most common reason: they did Evaluation Center plan to continue in the Pap Smear Evaluation Center not remember). these interventions to prevent at Brigham and Women’s Hospital future no-shows. w w w . da n a - fa r b e r . o r g /n u r s i n g 13

Venous Access Committee Updates The Venous Access Committee with the provider and care team, could be implemented for Dana-Farber (VAC), co-chaired by Susanne Conley, MSN, RN, AOCNS, CPON, which ultimately improves the patients with central venous access and Terry Mazeika, MSN, RN, OCN, developed an evidence- patient experience. devices. Flushing guidelines and based venous assessment tool to determine whether central access is The VAC also monitors patient literature review were presented to the required for administration of cancer treatments. The tool standardized outcomes related to intravenous VAC, which recommended monitoring the way nurses assess risk factors associated with peripheral venous therapy including chemotherapy the use of altepase tPA (a thrombolytic access in adult oncology patients. Its use was subsequently incorporated extravasations and central line agent that can be used to dissolve clots into an updated policy, which was informed by the Infusion Nurses associated blood stream infections. in CVADs) to assess whether the 0.9 Society and the Oncology Nursing Society standards. In 2018, the VAC recommended percent NS-only flushing protocol led The new nursing policy eliminated occurrence reporting system updates to an increase in catheter occlusions. the use of antecubital intravenous sites and limited a patient to four to reflect the standards of care in the There has been no reported increase intravenous sticks per day to receive cytotoxic agents. A pilot is underway extravasation policy. These updates related to this practice change. to ensure that all patients who have consult appointments will have a provide actionable, vein assessment prior to initiating treatment. The implementation of the trended data that tool supports nurses’ autonomy and enhances communication nurses can use to monitor compliance and develop improvement projects. A recall and subsequent shortage of heparin lock flush solution required a review of professional standards to ensure that flushing with 0.9 percent normal saline (NS)-only was a safe flushing protocol that Susanne Conley and Terry Mazeika CareDex Electronic Tool Piloted in The Integrative Nursing Program initiated a design thinking project to identify gaps in care experiences that could be improved by using human-centered design methods. Led by Shanna Hoffman, MSN, RN, AGCNS-BC, program director, the project team identified one such area to pilot an intervention – the Jimmy Fund Clinic, which serves pediatric patients. A focus group of Patient and Family Advisory Council members and Jimmy Fund Clinic nurses collaborated to create and pilot an electronic tool, the CareDex form, intended to enhance relationships between patients and members of their clinical team. Chelsea Proulx, BSN, RN, with a Jimmy Fund Clinic patient 14 NURSING and PATIENT CARE SERVICES: EXEMPLARY PROFESSIONAL PRACTICE

Scalp Cooling Pilot Looks at Hair Salvage in Breast Oncology Program Chemotherapy-induced alopecia (CIA) is one of the most Julie Foiadelli, BSN, RN, with patient Kathleen Begley common and emotionally distressing side effects of cancer treatment and one of the strongest deterrents for a woman Since November 2017, 89 breast cancer patients have deciding whether to undergo chemotherapy. participated in the pilot. Patients privately contract with PAXMAN company for the service, using cooling machines at DFCI. The Scalp cooling to prevent CIA has been standard in Europe team is reviewing outcomes related to patient satisfaction with for more than 40 years and is widely used in Canada. The hair salvage. The patients on taxane regimens achieved an 88 cooling causes vasoconstriction, which reduces blood percent success rate of hair salvage. Patients report that having flow to the hair follicles, therefore minimizing its uptake an option available that potentially minimizes hair loss gives them of the chemotherapy drug. Until recently, hospitals in the some control and privacy while undergoing cancer treatment. United States were hesitant to recommend scalp cooling Being able to assist patients in successfully managing alopecia because of a lack of quality randomized clinical trials. A 2015 made nursing supportive of the program. Plans are underway to randomized trial demonstrated safety and efficacy and led to expand the program to additional solid tumor treatment centers FDA approval of two scalp cooling systems. where scalp cooling has been found to be effective. At the beginning of 2017, Dana-Farber’s Breast Oncology Program in the Susan F. Smith Center for Women’s Cancers requested a scalp cooling pilot on Yawkey 9 for patients receiving taxane-based therapies. A multidisciplinary committee including clinical specialist Susanne Conley, MSN, RN, AOCNS, CPON; Allie Hershey, MSN, AOCNP; associate chief nurse Nancy Hilton, BS, RN, MS; Mary O’Malley, BSN, RN, OCN; Elahe Salehi, DNP, APRN, and clinical nurses convened and investigated vendor options. After selecting a vendor, the team created policies, nurse competencies, and patient education materials, and addressed operational issues critical to implementing a successful program beginning in November 2017. the Jimmy Fund Clinic the electronic medical record in June 2018. Since then, there has been a sustained increase in the The CareDex form is part of a patient’s electronic percentage of patients with a completed CareDex in medical record. Information can be added and accessed their chart. by all clinicians at any point in the care continuum. The form provides a place to document information about a The team is continuing to gather data on usability patient that may not be otherwise easily accessible but and has conducted three staff surveys (three, six, could enhance their quality of care. For example, patient and nine months after the project rollout) to gather preferences regarding dressing changes, integrative feedback. The CareDex project has been shared therapies that have helped, routines to enhance a sense with the informatics committee at Boston Children’s of safety, and favorite games, toys, and hobbies can Hospital, and work is underway to understand how this be documented. learning can inform the use of the electronic medical record for relationship-based care across the enterprise. With assistance from Boston Children’s Hospital’s informatics team, the CareDex form was added to w w w . da n a - fa r b e r . o r g /n u r s i n g 15

NEW KNOWLEDGE, INNOVATIONS, AND IMPROVEMENTS Annual Symposia Highlight Oncology Nurse Leaders One of the core pillars of the 2017-19 Dana-Farber Sponsored by the Center for Clinical and Professional NPCS strategic plan is to “Advance and Transform the Development (CCPD), the event was coordinated by Practice of Nursing.” To support this goal, Dana-Farber is nurse leader Kerry Hennessy, MSN, RN, AOCN, with committed to disseminating the latest advances in care help from a planning committee including Angela and research to oncology nurses at the Institute and to Creta, DNP, RN-BC, CNL, NE-BC; Anne Elperin, MSN, the greater oncology community. In 2018, DFCI-sponsored RN, AOCNP; Katie Fiel, MSN, RN, OCN; Colleen symposia focused on general oncology nursing and McLaughlin, BBA; and Patti Smith-Allen, MSN, RN. nursing research. In addition, the second annual Research Nurse The oncology nursing symposium, Updates and Symposium was held in September. Emerging Considerations in Oncology Nursing, held in June at Dana-Farber, was attended by nearly 150 nurses Of the many symposia held each year for Dana-Farber who had the opportunity to learn from DFCI nurses. In faculty and staff, few cover topics as diverse as CAR T-cell addition, keynote speaker Deborah Mayer, PhD, RN, therapy, the dermatological side effects of targeted drugs, spoke to colleagues about cancer survivorship. Mayer, the the art of informing patients about clinical trials, ethical director of Cancer Survivorship at the UNCS Lineberger issues associated with clinical research, and firsthand Comprehensive Cancer Center at the University of North accounts of patients’ clinical trial experiences. Carolina-Chapel Hill, noted that the country’s oncology caregivers will face financial and logistical challenges “The annual Research Nurse Symposium is an unless they change how they care for an aging group of opportunity for nurses from around New England to cancer survivors expected to increase 31 percent – to network, learn about new treatment modalities, gain nearly 26 million – by 2040. different perspectives on practice, and collaborate on issues that are important to the research community,” The day-long event featured these staff-led talks: says Kristen Legor, BSN, RN, OCN, JD, associate • Kecia Boyd, MSN, RN, AOCNS, BMTCN – chief nurse, Research, who leads Dana-Farber’s staff of 84 research nurses along with Caryn Caparrotta, Evolution of the Oncology Nurse: A Glimpse of BSN, RN, OCN. Past Patient Care • Elizabeth Buchbinder, MD – Immunotherapy Presenters at this year’s symposium: • T racy Daly, MSN, NP, and Shanna Hoffman, MSN, • C aryn Caparrotta, RN, BSN, OCN, and Kristen RN, AGCNS-BC – Integrative Oncology and Pain Management: Evidence-Based Interventions to Legor, BSN, RN, OCN, JD – When Clinical Trials Promote Comfort and Healing Go Wrong • K athleen McDermott, BSN, RN, OCN, BMTCN – • C olleen Dansereau, MSN, NP – CAR T-Cell CAR T-Cell Therapy: Concepts and Clinical Nursing Experience: A Patient’s Journey Considerations (a patient and spouse joined • S uzanne Ezrre, MSN, RN, and Carolyn McDermott and shared their experience going Goldhammer, BSN, RN, OCN – A Crisis of through the CAR T-Cell process) Conscience: Ethical Dilemmas in Research Nursing • P atti Smith-Allen, MSN, RN – Patient Education: • N icole LeBoeuf, MD, MPH – More Than Just a Rash: Using the Teach-Back Method in the Inpatient Setting Dermatologic Toxicities • Clare Sullivan, BSN, RN, OCN, MPH – Innovations • S arah Nikiforow, MD, PhD – Immune-Effector in Nursing: Pen, Paper, and the Clipboard Cell: Clinical Updates • Nikhil Wagle, MD – Cancer Precision Medicine • E ileen Regan, MSN, RN, OCN – Informed Consent: The Teachback Method 16 NURSING and PATIENT CARE SERVICES: NEW KNOWLEDGE

In November, Dana-Farber hosted the 2018 Dana- Farber/Brigham and Women’s Cancer Center Network Nursing Forum. The forum is held annually to encourage collaboration and learning among colleagues at DFCI as well as nurses from the Dana-Farber Cancer Care Collaborative sites. Emma Dann, DNP, RN, OCN, NEA-BC, associate chief nurse, Network, shares that, “the forum provides a unique opportunity for oncology nurses from various settings to come together for a shared purpose of education and networking.” The event’s planning committee included Dann and clinical specialists Megan Corbett, MSN, RN-BC, OCN, and Marylou Nesbitt, MSN, RN, AOCN. Presenters at the 2018 Network Nursing Forum: • Abigail Ciampa, MSN, ANP-BC – Oncologic Emergencies: How to successfully Identify and Treat • Eileen Duffey-Lind, MSN, APRN-BC, OCN – Preventing HPV: Update on Cancer Prevention Work • Kerry Beliveau, MSN, RN, OCN; Lori Buswell, MSN, RN, OCN; Ludmila Svoboda, BSN, RN, OCN, MA; Meghan Underhill-Blazey, PhD, APRN, AOCNS – Global Oncology: DFCI’s Center for Global Cancer Medicine • Shanna Hoffman, MSN, RN, AGCNS-BC – Human-Centered Design Approach for Clinical Problem-Solving • Domenic Leco and Mark Tomilson – Social Media and Oncology Nursing: Inherent Challenges Related to Personal and Professional Use Top photo: Deb Mayer, PhD, RN, AOCN, FAAN. Bottom photo: Suzanne Ezrre, MSN, RN. w w w . da n a - fa r b e r . o r g /n u r s i n g 17

CPIP Project Aims to Improve Patient Experience Waiting for a medical appointment can be frustrating Sheila Rozanski and Amy Ferreira to patients, particularly those who are undergoing cancer treatment. Often these delays are for necessary reasons, ensure that they would be understood. Clinic assistants such as preparing medications or validating orders. were engaged as key leaders in the process, implementing Knowing that some waiting is unavoidable, a team of face-to-face communication with patients every 30 minutes NPCS clinicians sought to test and implement ways to so patients understood the reason for the delay. standardize face-to-face communication about wait times. The pilot intervention decreased the number of patient Dana-Farber’s Clinical Process Improvement Leadership complaints about wait time, and the average number Program (CPIP) paired Nurse Director Sheila Rozanski, of patients inquiring about wait time decreased to an MSN, RN, OCN, with Lead Clinical Assistant Amy Ferreira. average of three. Rozanski and Ferreira plan to continue Rozanski and Ferreira, along with team members from implementing this work on other clinic floors. clinical floors, mapped out the infusion room check-in process on Yawkey 7, identifying 16 potential steps that may occur between the time patients check in to when they are seated for treatment. The team also reviewed data of patient inquiries about the wait during a two-week time period. During peak clinic hours of 11 a.m. and 2 p.m., patient inquiries ranged between six and eight. Their project sought to decrease patient inquiries to two through increased face-to-face communication and implement standard language about wait times. The phrases were first reviewed with Debbie Anderson, a member of the Patient and Family Advisory Council, to Digital Health at Dana-Farber The digital health movement is well tone for the rest of the day’s events Gabby Spear and her family underway at Dana-Farber, and clinical and ensured that the conversation and administrative leaders, researchers, was patient- and family-centered. complexities of creating an app that outside experts, and patients and would be well-utilized. their families are participating in the After developing the myDFCI app discussion. In an ongoing effort to bring for Apple devices in 2017, the Adult Spear, along with other Patient and people together to think through digital Patient and Family Advisory Council Family Advisory Council members, health, Dana-Farber hosted a Digital – supported by Renee Siegel, MSW, plans to continue her involvement Disruption Symposium in May in the LCSW – was often consulted regarding with ongoing digital health efforts at Yawkey Center for Cancer Care. app development and digital health Dana-Farber by supporting research at Dana-Farber. The Digital Disruption projects with digital components Leading the conversation was Symposium was not only an opportunity and partnering with senior leaders Gabby Spear, a breast cancer survivor, for Spear to share her experience on high-level decision-making. patient experience advocate, and as a breast cancer patient and how co-chair of Dana-Farber’s Adult Patient digital health could have improved and Family Advisory Council. Spear her experience, but also to provide began her speech by describing her guidance around app development. experience as a patient, and how it Spear and Siegel shared insights could have been improved using digital about the process of working with technology. Spear’s testimonial set the a pro-bono developer and the many 18 NURSING and PATIENT CARE SERVICES: NEW KNOWLEDGE

Dana-Farber Applies for MAGNET Fourth Magnet Designation BY THE NUMBERS Dana-Farber applied for its fourth Magnet Recognition Program® designation in August 2018. This gold standard 8% for nursing is a credential granted to approximately 8 percent of hospitals nationally and is emblematic of hospitals DFCI’s commitment to providing patients and families nationally with the most expert, compassionate nursing care. Dana-Farber has earned Magnet designation from the are Magnet American Nurses Credentialing Center (ANCC) three designated times: in June 2005, in November 2009, and again in July 2014. The 2018/19 redesignation effort includes 8 nursing services at all Dana-Farber care sites, including satellite practices at Milford Regional Medical Center, hospitals in St. Elizabeth’s Medical Center, South Shore Hospital, Massachusetts and New Hampshire Oncology-Hematology, as well as physician practices, the DFCI Inpatient Hospital, and are Magnet designated the Longwood campus. 3 The 2,600-page application document addressed 69 standards and included 98 narratives and times DFCI 30 interdisciplinary stories. Sixty colleagues contributed has been to collection of data and narratives that included designated highlighting CAR T-cell therapy, the Adult Survivorship Program, ACE training, Patient Contact Center, first designated chemotherapy administration safety, and CPIP projects. 2005 Dana-Farber anticipates a site visit in spring 2019 to 69 validate its application. ANCC Magnet 2018 American Nurses Credentialing Center Magnet Conference attendees standards to meet for designation 50% of standards focus on outcomes 98 narratives written 49 sources of evidence provided 60+ interprofessional DFCI colleagues outside of Nursing contributed to data and narratives w w w . da n a - fa r b e r . o r g /n u r s i n g 19

EMPIRICAL OUTCOMES Measuring Quality of Nursing Care Recognizing that nursing contributes to organizational Program to Reduce Ambulatory Central Line Associated and patient outcomes, the ANCC Magnet framework Blood Stream Infections (CLABSI) to address CLABSI emphasizes the importance of developing structures and rates in the Jimmy Fund Clinic (JFC). processes within a professional practice environment that supports a high level of quality nursing care. To The central venous catheter (CVC) caregiver education ensure quality is achieved, organizations are required to improvement initiative was led by JFC clinical nurse compare unit-level outcome data to national comparison Denise Desrochers, BSN, RN, CPON, who served as the benchmarks. Outcome data include: initiative’s outpatient champion; Boston Children’s Hospital clinical nurse Margaret Brill-Conway, BSN, RN, CPHON, • nurse satisfaction the initiative’s inpatient champion; and Pediatric Oncology • nurse education and certification Physician Chris I. Wong, MD, MPH, CPPS, who led the • patient satisfaction with nursing care quality improvement and monitoring component of the • n urse-sensitive indicators (chemotherapy project. Pediatric Oncology Physician Amy Billett, MD, served as an advisor. The goal of the CVC caregiver extravasations, falls with injuries, catheter- education initiative was to decrease the ambulatory associated urinary tract infections, central line- pediatric CLABSI rate through the development and associated bloodstream infections). implementation of a standardized approach to CVC Some of the benchmarks used for this year’s Magnet caregiver education and support. document submission include benchmarks in the National Database of Nursing Quality Indicators and those As indicated in the following graph, the CVC caregiver established by the Cancer Centers Consortium Nursing- education program developed and implemented by the Sensitive Indicators consensus group and Comprehensive interprofessional improvement team was associated with Cancer Center Consortium for Quality Improvement. a sustained reduction in the JFC CLABSI rate. Before Additionally, organizations are required to demonstrate this was developed, the CLABSI rate ranged between that they are continually reviewing and analyzing data and 0.21-0.56 CLABSIs per 1,000 central line days. After developing performance improvement plans with clinical the CVC caregiver education program was developed, a nurses to develop interventions to improve outcomes. total of 182 teaching sessions were conducted, and the A performance improvement example showcased in CLABSI rate decreased to 0.12 CLABSIs per 1,000 central the 2018 submission was A Family-Centered Education line days in the first quarter of 2018. EP13EO: JFC CLABSI Rate Q1 2015 - Q1 2018 CLABSI per 1,000 Line days (rate) 0.6 0.56 0.5 0.4 0.37 0.3 0.2 0.21 0.26 0.29 0.28 0.1 0.24 0.23 0.18 0.21 0.13 0.12 0 Q1 2015 Q2 2015 Q3 2015 Q4 2015 Q1 2016 Q2 2016 Q3 2016 Q4 2016 Q1 2017 Q2 2017 Q3 2017 Q4 2017 Q1 2018 Pre-Intervention Intervention Post-Intervention CLABSI rate 0.21 0.56 0.26 0.29 0.24 0.37 0.28 0.13 0.18 0.23 0.21 0.12 20 NURSING and PATIENT CARE SERVICES: EMPIRICAL OUTCOMES

Professional Practice Model The Nursing Council finalized and approved an updated Professional Practice Model (PPM) schema in fall 2017. The first phase of dissemination into practice involved creating and presenting a one-hour continuing nursing education program targeted at specific groups of nurses across the enterprise, distributing PPM badge cards, and handing out framed images of the revised PPM schema to each practice area. The second phase began with a continuing education offering in May 2018. Magnet Champions have been charged with engaging all clinical nurses in the dissemination of the PPM. Champions are using creative methods to engage their colleagues in relating everyday practice stories back to the tenets of the PPM. To incentivize maximum participation, a competition between units is underway and the winning unit will be awarded a prize in 2019. SY ATIENT & F P AMILY YNERG NURSE www.dana-farber.org/nursing 21

Patients Report High Satisfaction with Nursing Care The effectiveness of the nursing professional practice sample of cancer centers that use the Outpatient Oncology model (PPM) is continuously evaluated through review of survey tool, the Consortium of Comprehensive Cancer Centers outcomes that include nurse satisfaction, patient clinical for Quality Improvement, and the Magnet Peer Group. The outcomes, and patient satisfaction with nursing care. Nursing Department analyzes the Patient Engagement Dana-Farber has consistently demonstrated strong domain very closely because it highlights Dana-Farber’s performance in nurse-related patient-satisfaction domains, strong commitment to a core component of the PPM, the outperforming in all four categories (Patient Engagement, primary nursing/relationship-based care delivery system that Patient Education, Responsiveness, Courtesy and Respect) impacts whether patients feel included in their care. reported to the American Nurse Credentialing Center (ANCC) in August. Patients report a high sense of inclusion in decision making and are confident in how to manage their care at home. During The comparison benchmarks Dana-Farber uses include the past year, the majority of areas have consistently performed the 515-2 Dana-Farber Custom Peer Group, which contains a higher than comparison peer groups (see graphs at right). Dana-Farber patient Marie with (left to right) Maura Dacey, BSN, RN; Ashleigh Eberly Puleo, PA-C; and Colleen Chin, BSN, RN. 22 NURSING and PATIENT CARE SERVICES: EMPIRICAL OUTCOMES

Patient Engagement Ambulatory – Longwood Adult, Satellites, Community Cancer Care “Efforts to include you in decisions about your treatment” October 2017 – September 2018 100 Mean Score 95 90 85 Yawkey 06 80 2018 Q1 2018 Q2 2018 Q3 Yawkey 07-08 2017 Q4 98.4 92 94.9 Yawkey 09 93.2 95.5 96.3 95.2 Yawkey 10 91.2 94.9 94.8 95.7 Yawkey 11 94.7 93.9 95 97.1 Londonderry Satellite 96 92.8 97.2 93.2 Milford Hospital Satellite 95.3 96.8 96.7 96.3 South Shore Hospital Satellite 96.6 95.8 93.7 93 St. Elizabeth’s Satellite 93 94 96 96.8 DFCCC Lawrence 92.8 92.2 96.3 95.5 DFCCC Methuen 92.8 93.8 90.9 90.8 DFCCC Weymouth 100 94.4 92.9 94.2 C4QI Custom Mean 94.4 89.3 96.2 95.4 100 92.5 92.4 92.5 92.5 Patient Engagement Patient Engagement Ambulatory – Longwood Pediatric DFCI Inpatient Units (6B, 6C, 6D) “Efforts to include you in decisions about your treatment” “When I left the hospital, I had a good understanding of the things I was responsible for in managing my health” October 2017 – September 2018 October 2017 – September 2018 100 90 Mean Score100 80 Mean Score 70 95 60 90 85 50 2017 Q4 2018 Q1 2018 Q2 2018 Q3 89.5 88.4 84.7 92.9 80 2017 Q4 2018 Q1 2018 Q2 2018 Q3 DFCI IPH 6B 94.2 85.7 92.2 84.7 96.5 96.5 95.5 96.2 DFCI IPH 6C 89.7 87.9 86.9 87.5 JFC 92.6 92.7 92.6 92.7 DFCI IPH 6D 83.6 83.4 83.5 83.5 515-2 Custom Mean Magnet Peer Group www.dana-farber.org/nursing 23

ACCOMPLISHMENTS Reward and Recognition • K athleen Bielagus, BSN, RN, Thomas M. Kloss Nursing • A ngela Kigathi, MSN, RN, and Inez Robinson, RN, Leadership Award OCN, New England Regional Black Nurses Association (NERBNA) Inc. Excellence in Nursing Practice Award • M itsie Cazeau, BSN, RN, New England Regional Black Nurses Association (NERBNA) Inc. Excellence in Nursing • N ane Kouyoumjian, Culture of Care Award for Leadership Award Excellence in Patient Experience • J ames Constantine, Catherine Rhinehart, BSN, RN, • F ran Leonard, MSN, RN, AOCN, Honorable Mention OCN, and Katherine Stephans, MSN, NP, Preceptor Award for the 2018 Schwartz Center National Compassionate Caregiver of the Year Award • E ileen Duffey-Lind, MSN, APRN-BC, OCN, Nominated for ANCC Magnet Nurse of the Year Award • J ill MacDonald, BSN, RN, CPON, and Rachel Terranova, BSN, RN, CPON, First Place Poster, at • A my Ferreira, Damon Morris, and Lindsay Speight, APHON (Association of Pediatric Hematology Oncology Outstanding Clinic Assistant Award Nurses) 42nd Annual Conference and Exhibit • Donna Flynn, RN, OCN, Certified Nurse of the Year Award • J eanine McManus, BSN, RN, and Cameron Sze, BSN, RN, Award for Excellence in Relationship-Based • Kara Garfield, MPA; Ann Marie Ricciarelli, BSN, RN, Nursing Care OCN; Patricia Severns, MSN, RN, ANP-BC; and Colleen Whitehouse, DNP, RN, OCN, Partners in Excellence Award • M eghan Underhill-Blazey, PhD, APRN, AOCN, Oncology Nursing Society Victoria Mock New • N ancy Grant, RN, OCN, President’s Award for Investigator Award Nursing Excellence NP Graduate and Nursing Student Preceptors: Fall 2017–18 Brian Beardslee, MSN, RN Ginger Dalton, MSN, NP Ilene Galinsky, MSN, NP Early Drug Development Center Hematologic Malignancies Hematologic Malignancies Kelly Boyle, MSN, RN, CNOR Giuliana DeMarchi, MS, NP Nina Grenon, DNP, AGCNP-BC, AOCN Lab Services Gastrointestinal Oncology Gastrointestinal Oncology Pam Calarese, MSN, NP Lisa Doherty, MSN, APRN-BC, OCN Jason Glass, MSN, NP Thoracic Oncology Neuro-Oncology Head and Neck Oncology Abigail Ciampa, MSN, ANP-BC Toni Dubeau, MSN, AGNP-BC Cherice Hermann, BSN, RN, OCN Dana-Farber Cancer Institute Hematologic Malignancies DF/NHOH at St. Elizabeth’s Medical Center Katherine Edmonds, MSN, NP Shanna Hoffman, MSN, RN, AGCNS-BC Melissa Cochran, MSN, FNP-BC Hematologic Malignancies Integrative Nursing Hematologic Malignancies Lauren Engel, MSN, NP Amy Joyce, MSN, NP, AOCN Angela Creta, DNP, RN-BC, CNL, NE-BC Genitourinary Oncology Hematologic Malignancies Center for Clinical and Professional Development Elisa Frederick, MSN, NP Lisa Juden, MSN, NP Lauren Czapla, MSN, NP, AOCNP Research Nursing Gynecologic Oncology Breast Oncology 24 NURSING and PATIENT CARE SERVICES: ACCOMPLISHMENTS

New Degree Attainment NAME UNIT DEGREE SCHOOL Alyse Algera Yawkey 8 BSN Northeastern University Caitlin Brown Jimmy Fund Clinic MSN Rivier University McKayla Burns Yawkey 10 MSN Boston College Kerri Cavanaugh Jimmy Fund Clinic MSN Salem State University Lisa Chicko Dana-Farber/New Hampshire MSN, Nursing Education Franklin Pierce University Oncology-Hematology Paige Collicchio DFCI Inpatient Hospital BSN Fitchburg State University Emma Dann Network DNP Simmons University Michael Humes Yawkey 8 BSN Northeastern University Amanda Lulloff Jimmy Fund Clinic PhD Boston College Terry Mazeika Yawkey 6 MSN Kaplan University Maritza Nassif Patient & Family Programs MEdn Emmanuel College and Services Kim Noonan Yawkey 7 DNP Simmons University Rachel Pozzar Phyllis F. Cantor Center PhD Northeastern University Adonica Racicot MSPC University of Colorado DF/BWCC at Milford Regional Michelle Ranaghan Medical Center MSN, Nursing Education Capella University Elahe Salehi Yawkey 6 DNP MGH Institute of Health Professions Colleen Whitehouse Yawkey 9 DNP MGH Institute of Health Professions Radiation Oncology Jean Landry, MSN, ANP-BC Melissa O’Connor, MSN, NP, CPON Jennifer Spidle, MSN, NP, CPON Breast Oncology Pediatric Oncology Pediatric Oncology Sheila Macauley, BSN, RN, OCN Kathleen Polson, MSN, APRN Jenn Stefanik, MSN, NP DFCCC Weymouth Sarcoma Neuro-Oncology Elyse Mandell, MSN, NP Cathleen Power, MSN, NP Katey Stephans, MSN, NP Benign Hematology Thoracic Oncology Hematologic Malignancies Jen McKenna, MSN, NP Elahe Salehi, DNP, APRN Barbara Virchick, MSN, ANP-BC, OCN Breast Oncology Breast Oncology Hematologic Malignancies Margaret McMullin, MSN, RN, AOCN Lindsay Shaw, MSN, RN, AOCNP Casey Wall, MSN, NP, CPON Thoracic Oncology Breast Oncology Pediatric Oncology Suzanne Menon, MSN, NP, OCN Sara Shobin, MS, RN, CPHON Andrew Wolanski, DNP, AOCNP Gynecologic Oncology Pediatric Oncology Early Drug Development Center Kim Noonan, DNP, RN, AOCN Karen Sommer, MSN, ANP-BC Mary Ann Zimmerman, MSN, NP, CPNP Hematologic Malignancies Gastrointestinal Oncology Pediatric Neuro-Oncology www.dana-farber.org/nursing 25

New Certifications NAME UNIT/DEPARTMENT DEGREE Paula Aguilera Yawkey 6 OCN Kelsey Baker-Brooks Yawkey 8 OCN Gina Barbieri DFCI Inpatient Hospital OCN Hannah Bary DFCCC Lawrence OCN Kerry Beliveau Yawkey 6 OCN Cindy Cao Yawkey 10 BMTCN Amanda Carnes Jimmy Fund Clinic CPHON Ceceley Chambers DF/BWCC at Milford Regional Medical Center APBCC Caitlin Coppenrath DFCCC Methuen OCN Megan Corbett Network OCN Emma Dann Network NEA-BC Kathy Guimond Yawkey 7 AHN-BC Christina Hale DF/BWCC in Clinical Affiliation with South Shore Hospital OCN Rebecca Klass DFCCC Weymouth OCN Paula Koppel Integrative Nursing AHN-BC Helen-Lori Maclellan Yawkey 11 OCN Katherine Magni DF/BWCC at Milford Regional Medical Center OCN Pilar McCann Interpreter Services CMI - Spanish Mary-Ann McCue DFCCC Weymouth OCN Susan O’Connor DF/BWCC in Clinical Affiliation with South Shore Hospital OCN Nancy Peña Patient & Family Programs and Services ONP-CG Carol Ann Perry Yawkey 2 OCN Chelsea Proulx Jimmy Fund Clinic CPHON Emily Ranaghan Jimmy Fund Clinic CPHON Bethany Rang Yawkey 5 OCN Kristin Souza Jimmy Fund Clinic CPHON Lauren Sullivan Yawkey 7/ Yawkey 8 AGCNS-BC Colleen Whitehouse Radiation Oncology OCN Dalida Yeroshalmi Yawkey 2 VA-BC 26 NURSING and PATIENT CARE SERVICES: ACCOMPLISHMENTS

Each year The Boston Globe publishes a special “Salute to Nurses” supplement in which patients and families can pay tribute to those who care for them. This year’s honorees included: • P aula Buckley, BSN, RN, VA-BC, • Kristen Graham, BSN, RN, CPON, • Courtney Shea, BSN, RN, Venous Access Nurse Staff Nurse Staff Nurse • C indy Cao, BSN, RN, OCN, • A nne Gray, BSN, RN, • Robin Sommers, DNP, NP, AOCNP, BMTCN, Staff Nurse Program Nurse Nurse Practitioner • Carla Chapman, BSN, RN, • J illian Hoffman, BSN, RN, • Despina Stavros, BSN, RN, Staff Nurse Staff Nurse Staff Nurse • Virginia Dalton, MSN, NP, • Kathy Houlahan, MHA, MSN, RN, • K atherine Stephans, MSN, NP, Nurse Practitioner NE-BC, Nursing Director Nurse Practitioner • Erin Drury, BSN, RN, OCN, • E lizabeth Llewellyn, BSN, RN, • Ann Stewart, MSN, NP, ANP, Staff Nurse OCN, Staff Nurse Nurse Practitioner • L auren Engel, MSN, NP, • Jennifer Lowell, BSN, RN, • J ackie Tuskan, BSN, RN, OCN, Nurse Practitioner Staff Nurse Staff Nurse • Katherine Fleming-Flagg, BSN, • Jennifer McKenna, MSN, NP, • M eghara Walsh, BSN, RN, RN, OCN, Staff Nurse Nurse Practitioner Research Nurse • B rittney Fontana, BSN, RN, • Elizabeth Kaylin, BSN, RN, OCN, • A nnette Werger, MSN, NP, PNP, Research Nurse Staff Nurse Nurse Practitioner • Karen Francoeur, BSN, RN, • Suzanne Oliver, BSN, RN, OCN, • A lyssa Ywuc, BSN, RN, OCN, Research Nurse Staff Nurse Staff Nurse DAISY Awards are presented quarterly by Anne H. Gross, PhD, RN, NEA-BC, FAAN, and nurse leaders to recognize the extraordinary work nurses do every day. Here are this year’s winners. Nancy Grant, Catherine Hulme- Melissa Jasset, Adonica Racicot, BSN, RN, OCN Freudenberger, MSN, RN MSPC, RN, OCN Dana-Farber Cancer MS, BSN, RN, OCN Dana-Farber Cancer DF/BWCC at Institute at DF/BWCC at Institute, Yawkey 6 Milford Regional St. Elizabeth’s Milford Regional Medical Center Medical Center Medical Center www.dana-farber.org/nursing 27

Professional Leadership Roles NAME PROFESSIONAL ORGANIZATION LEADERSHIP ROLE Brian Beardslee, MSN, RN Boston Chapter Oncology Nursing Society (ONS) Nominating Committee Boston Chapter ONS Program Planning Committee International Association of Clinical Research Nurses Conference Planning Committee (IACRN) Member IACRN Core Competencies Review Committee Member IACRN Marketing and Communications Committee Member IACRN Marketing and Membership, Education Committee Lisa Caradonna, BSN, RN, OCN Southern NH ONS Secretary Michael Casey, APRN-BC, FNP Health Information Outpatient NP Management Committee Representative Lisa Chicko, RN, BA, OCN Manchester Community College Advisory Council for Nursing Program Franklin Pierce University Instructor of Nursing Southern NH ONS Board Director at Large Angela Creta, DNP, RN-BC, American Nursing Credentialing Center ANCC Magnet Appraiser CNL, NE-BC Mary E. Cooley, PhD, RN, FAAN ONS Scholar-In-Residence Maura Dacey, BSN, RN Boston Chapter ONS Director At Large Emma Dann, DNP, RN, OCN, Southern NH ONS President NE-BC St. Anselm Continuing Education Leadership Conference Planning Committee Northern New England Clinical Oncology Society Board Member Boston College Faculty, RN Refresher Course Eileen Duffey-Lind, MSN, RN, HPV/Cervical Cancer Summit at DFCI Chair CPNP Massachusetts DPH HPV/CC Working Group Co-Chair Cervical Cancer Free America Co-Chair, Mass Chapter Mass Coalition for HPV and HPV Related Cancers Awareness Chair Anne H. Gross, PhD, RN, American Academy of Nursing Chair, Fellows Selection NEA-BC, FAAN Committee Greater Boston Nursing Collective Board Member Mosaic – DFCI Employee Resource Group Executive Sponsor University of Massachusetts, Boston; College of Nursing and Member, Dean’s Advisory Board Health Sciences 28 NURSING and PATIENT CARE SERVICES: ACCOMPLISHMENTS

NAME PROFESSIONAL ORGANIZATION LEADERSHIP ROLE Anne H. Gross, PhD, RN, FAAN, National Comprehensive Cancer Network (NCCN) Executive Sponsor, Advanced NEA-BC (continued) Practice Practitioner Committee Member, Best Practices NCCN Committee Member, Nurse Executive Group Rebecca Guy-Hamilton, BSN, NCI-Designated Comprehensive Cancer Centers Council Representative RN, OCN Massachusetts Nurses Association (MNA) Stakeholder Panel Member Nancy Hilton, BS, RN, MS The Joint Commission Cancer Center Project Chair Shanna Hoffman, MSN, RN, Integrative Nursing Pain Consortium of Boston Program Committee Member AGCNS-BC President Greater Boston Nursing Collective Member, Educational Committee Member, Boston Chapter Board Anna Lefebvre, MSN, CPNP, Boston Association of Pediatric Hematology/Oncology Secretary CPON Nurses (APHON) Social Media Coordinator Kristen Legor, JD, RN, OCN IACRN Vice President of the Board Secretary IACRN Director at Large Amanda Lulloff, MS, RN, PCNS, Boston APHON Secretary CPHON Marketing and Communications Mary O’Driscoll, BSN, RN OCN Central Mass ONS Committee Member Board of Directors - Vice Nina Scott, CMI Forum for the Coordination of Interpreter Services President Journal of Dermatology Nursing - Commission for Medical Interpreter Education Manuscript Reviewer (Division of IMIA) Dermatology Specialty Group Representative Karyn Stebbins, BSN, RN, OCN Southern NH ONS Fellow Clare Sullivan, MPH, BSN, RN, Cancer Patient Education Network OCN Treasurer Co-Chair Bargaining Committee Cameron Sze, BSN, RN IACRN Marianne Tawa, MSN, NP Cutaneous Lymphoma Foundation Dermatology Nurses’ Association American Academy of Nurse Practitioners (AANP) National Task Force Validation Panel for the Development of Dermatology Nurse Practitioner Competencies Meghan Underhill-Blazey, PhD, Leadership Institute Society of Behavioral Medicine APRN, AOCN Andrew Wolanski, DNP, APN-BC Boston Chapter ONS MNA www.dana-farber.org/nursing 29

Publications Fawcett, J., Amweg, L., Legor, K., Kim, B.R. and Irwin, M.M., Dudley, W., Northouse, L., Berry, D.L., Maghrabi, S. “More Thoughts About Conceptual Models Mallory, G.A. “Oncology Nurses’ Knowledge, Confidence, and Literature Reviews: Focus on Population Health.” and Practice in Addressing Caregiver Strain and Burden.” Nursing Science Quarterly. 2018 October 31 DOI: Oncology Nursing Forum. 2018; Mar 1,45(2):187-196. DOI: 10.1177/0894318418792878 10.1188/18.ONF.187-196 Berry D.L., Blonquist T., Nayak M.M., Grenon N., Momani Budhrani-Shani, P., Chau, N.G., Berry, D.L., “Psychosocial T.G., McCleary N.J. “Self-care Support for Patients with Distress and the Preferred Method of Delivery of Mind-Body Gastrointestinal Cancer: iCancerHealth,” Applied Clinical Interventions Among Patients with Head and Neck Cancer.” Informatics. 2018; Oct,9 (4):833-840. DOI: 10.1055/s-0038- Patient Related Outcome Measures. 2018; Apr 3,9:129-136. 1675810. Epub 2018 Nov 21. DOI: 10.2147/PROM.S149978. eCollection 2018. Sun, M., Cole, A.P., Hanna, N., Mucci, L.A., Berry, D.L., Blok, A.C., Blonquist, T., Nayak, M.M., Somayaji, D., Basaria, S., Ahern, D.K., Kibel, A.S., Choueiri, T.K., and Crouter, S.E., Hayman, L.L., Colson, Y.L., Bueno, R., Trinh, Q.D., “Cognitive Impairment in Men with Prostate Emmons, K.M., Cooley, M.E. “Feasibility and Acceptability Cancer Treated with Androgen Deprivation Therapy: of ‘Healthy Directions’ A Lifestyle Intervention for Adults A Systematic Review and Meta-Analysis.” Journal of with Lung Cancer” Psycho-Oncology. 2018; Jan,27(1):250- Urology. 2018; Jun,199(6):1417-1425. DOI: 10.1016/j. 257. DOI: 10.1002/pon.4443. Epub 2017 May 31. juro.2017.11.136. Epub 2018 Feb 2. Davies, J.K., Brennan, L., Wingard, J., Cogle, C., Kapoor, Berry, D.L., Blonquist, T., Nayak, M.M., Roper, K., Hilton, N., N., Shah, A., Dey, B., Spitzer, T., De Lima, M., Cooper, L., Lombard, H., Hester, A., Chiavacci, A., Meyers, S., and Thall, P., Champlin, R., Nadler, L., and Guinan, E. ”Infusion McManus, K. “Cancer Anorexia and Cachexia: Screening in of Low Doses of Allonaergized Donor Lymphocytes an Ambulatory Infusion Service and Nutrition Consultation.” Improves Immune Reconstitution After Haploidentical Clinical Journal of Oncology Nursing. 2018; Feb 1,22(1):63- Haematopoietic Stem Cell Transplantation.” Clinical Cancer 68. DOI: 10.1188/18.CJON.63-68. PMID: 29350696. Research. Published Online First May 16, 2018; DOI: 10.1158/1078-0432.CCR-18-0449. Berry, D.L., Blonquist, T., Pozzar, R., Nayak, M.M. “Understanding Health Decision Making: An Exploration Cooley, M.E., Abrahm, J.L., Berry, D.L., Rabin, M.S., Braun, of Homophily.” Social Science & Medicine. 2018; I.M., Paladino, J., Nayak, M.M., and Lobach, D.F. “Algorithm- Oct,214:118-124. doi: 10.1016/j.socscimed.2018.08.026. Based Decision Support for Symptom Self-Management Epub 2018 Aug 24. DOI: 10.1016/j.socscimed.2018.08.026 among Adults with Cancer: Results of Usability Testing.” BMC Medical Informatics and Decision Making. 2018; May Berry, D.L., Hong, F., Blonquist, T., Halpenny, B., Filson, 29;18(1):31. DOI: 10.1186/s12911-018-0608-8. C.P., Master, V.A., Sanda, M.G., Chang, P., Chien, G.W., Jones, R.A., Krupski, T.L., Wolpin, S., Wilson, L., Hayes, Cooley, M.E., Poghosyan, H., Sprunck-Harrild, K., J.H., Trinh, Q.D., Sokoloff, M., and Somayaji, P. “Decision Winickoff, J.P., Edge, S.B., and Emmons, K.M. “Tobacco Support with the Personal Patient Profile-Prostate: A Treatment Implementation Within 28 Commission on Multicenter Randomized Trial.” Journal of Urology. Volume Cancer Accredited Programs in the Northeast Region of 199, Issue 1. 2018. the USA: A Pilot Study.” Translational Behavioral Medicine. 2018; Sep 8;8(5):706-713. DOI: 10.1093/tbm/ibx024. Fadol A.P., Mendoza T.R., Lenihan D., Berry D.L., “Addressing the Symptom Management Gap in Patients Lee, H., Kim, D., Kiang, P.N., Cooley, M.E., Shi, L., Thiem, with Cancer and Heart Failure Using the Interactive Voice L., Kan, P., Chea, P., Allison, J., and Kim, M. “Awareness, Response System: A Pilot Study.” Journal of Advanced Knowledge, Social Norms, and Vaccination Intentions Practice Oncology. 2018; 9(2):201–214 DOI: 10.6004/ Among Khmer Mother-Daughter Pairs.” Ethnicity & Health. jadpro.2018.9.2.6 2018; Aug 24, 1-13. DOI: 10.1080/13557858.2018.1514455. 30 NURSING and PATIENT CARE SERVICES: ACCOMPLISHMENTS

Lee, H., Kim, M., Cooley, M.E., Kiang, P.N., Kim, D., Knoerl, R., Chornoby, Z., and Smith, E.M.L., “Estimating Tang, S., Shi, L., Thiem, L., Kan, P., Peou, S., Touch, C., the Frequency, Severity, and Clustering of SPADE Chea, P., and Allison, J. “Using Narrative Intervention for Symptoms in Chronic Painful Chemotherapy-Induced HPV Vaccine Behavior Change among Khmer Mothers Peripheral Neuropathy.” Pain Management Nursing. 2018; and Daughters: A Pilot RCT to Examine Feasibility, Aug;19(4):354-365. DOI: 10.1016/j.pmn.2018.01.001. Acceptability, and Preliminary Effectiveness.” Applied Nursing Research. 2018; Apr;40:51-60. DOI: 10.1016/j. Knoerl, R., Hong, F., Blonquist, T., Berry, D.L., “Exploring apnr.2017.12.008. Epub 2017 Dec 18. the Impact of Electronic Self-Assessment and Self- Care Technology on Participant Adherence to Clinician Poghosyan, H., Moen, E.L., Kim, D., Manjourides, J., Recommendations and Self-Management Activity for Cooley, M.E. “Social and Structural Determinants Cancer Treatment-Related Symptoms.” Journal of Medical of Smoking Status and Quit Attempts Among Adults Internet Research Cancer. Published online 2018 Dec 4. Living in 12 US States, 2015.” American Journal of DOI: 10.1186/s12885-018-5093-z Health Promotion. 2018; Aug 2:890117118792827. DOI: 10.1177/0890117118792827. [Epub ahead of print] Knoerl, R., Smith, E.M.L., Barton, D.L., Williams, D.A., Holden, J.E., Krauss, J.C., and LaVasseur, B., “Self-Guided Ehrlich, O., Walker, R.K. “Recruiting and Retaining Online Cognitive Behavioral Strategies for Chemotherapy- Patient-Caregiver-Nurse Triads for Qualitative Hospice Induced Peripheral Neuropathy: A Multicenter, Pilot, Cancer Pain Research.” The American Journal of Hospice Randomized, Wait-List Controlled Trial.” The Journal & Palliative Care. 2018; Jul;35(7):1009-1014. DOI: of Pain. 2018 Apr;19(4):382-394. DOI: 10.1016/j. 10.1177/1049909118756623. Epub 2018 Feb 19. jpain.2017.11.009. Epub 2017 Dec 8. Kanzawa-Lee, G.A., Harte, S.E., Bridges, C.M., Brummett, Pozzar, R., Baldwin, L.M., Goff, B.A., and Berry, D.L., C., Clauw, D.J., Williams, D.A., Knoerl, R., and Lavoie “Patient, Physician, and Caregiver Perspectives on Ovarian Smith, E.M. “Pressure Pain Phenotypes in Women Before Cancer Treatment Decision Making: Lessons from a Breast Cancer Treatment.” Oncology Nursing Forum. 2018; Qualitative Pilot Study.” Pilot Feasibility Study. 2018 Jul Jul 01, 45(4):483-495. DOI: 10.1188/18.ONF.483-495. 4;4:91. DOI: 10.1186/s40814-018-0283-7. eCollection 2018. Knoerl, R., Barton, D.L., Holden, J.E., Krauss, J.C., Lathan, C., Akindele, R., Svodoba, L., and Gunderson, D. LaVasseur, B., and Smith, E.M.L. “Potential Mediators of “Self Reported Financial Stress Among Patients Evaluated Improvement in Painful Chemotherapy-Induced Peripheral at a Community Cancer Program” Journal of Clinical Neuropathy via a Web-Based Cognitive Behavioral Oncology. 2017 May 30. DOI: 10.1200/JCO.2017.35.15_ Intervention.” Canadian Oncology Nursing Journal. 2018; suppl.6553 Epub 2017 May 30 Jul 28(3), 178-183. DOI: 10.5737/23688076283178183. Jones, T., Duquette, D., Underhill, M., Ming, C., Mendelsohn- Knoerl, R., Bridges, C., Smith, G.L., Yang, J.J., Kanazawa- Victor, K.E., Anderson, B., Milliron, K.J., Copeland, G., Janz, Lee, G. Smith, E.M.L. “Chemotherapy-Induced Peripheral N.K., Northouse, L.L., Duffy, S.M., Merajver, S.D., and Neuropathy: Use of an Electric Care Planning System to Katapodi, M.C. “Surveillance for Cancer Recurrence in Long- Improve Adherence to Recommended Assessment and term Young Breast Cancer Survivors Randomly Selected from Management Practices.” Clinical Journal of Oncology a Statewide Cancer Registry.” Breast Cancer Research and Nursing. 2018; 22(5). Treatment. 2018 May;169(1):141-152. DOI: 10.1007/s10549- 018-4674-5. Epub 2018 Jan 20 Smith, E.M.L., Knoerl, R., Yang, J.J., Kanzawa-Lee, G., Lee, D., and Bridges, C.M. “In Search of a Gold Underhill, M., Hong, F., Lawrence, J., Blonquist, T., and Standard Patient-Reported Outcome Measure for Use in Syngal, S., “Relationship Between Individual and Family Chemotherapy-Induced Peripheral Neuropathy Clinical Characteristics and Psychosocial Factors in Persons Trials.” Cancer Control: Journal of the Moffitt Cancer with Familial Pancreatic Cancer.” Psychooncology. 2018 Center. 2018; Jan-Mar;25(1):1073274818756608. DOI: Jul;27(7):1711-1718. DOI: 10.1002/pon.4712. Epub 2018 10.1177/1073274818756608. Apr 19. www.dana-farber.org/nursing 31

Presentations Clinical Process Improvement Fuller, F. “A Multidisciplinary Process Improvement Project Program Presentations to Improve Administration of Oral Chemotherapy.” Oncology Nursing Society Congress. May 2018. Washington, DC. Corbett, M. “Utilizing Electronic Communication Efficiently. Influences on the Radiation Oncology Treatment Planning Gorman, D. “Managing Pain in the Face of Substance Misuse: Process.” Partners Clinical Process Improvement Program. June Practical Approaches and Tools in Palliative Care.” American 2018. Boston, MA. Academy of Hospice and Palliative Medicine Annual Assembly. March 2018. Boston, MA. Magni, K., Proulx, M.B. “Initial Nursing Assessments.” Partners Clinical Process Improvement Program. June 2018. Gorman, D. “The Opioid Crisis; Nurses Role in Caring for Boston, MA. Patients with Pain and Misuse.” Art and Science of Palliative Care Nursing. June 2018. Boston, MA. Rozanski, S., Ferreira, A. “Improving Wait Time, Communicating in Adult Ambulatory Clinic.” Partners Clinical Gorman, D. “Caring for Patients with Pain and a History of Process Improvement Program. June 2018. Boston, MA. Addiction or Misuse.” Practical Aspects of Palliative Care. September 2018. Boston, MA. Zimmer, L., Colicchio, L. “Primary Nursing in an Ambulatory Setting: A Model for Best Practice.” Partners Jabaley, T. “A Patient-Centered Decision Aid for Previvors.” Clinical Process Improvement Program. June 2018. Boston, MA. Oncology Nursing Society Congress. May 2018. Washington, DC. Panel Hoffman, S., Sullivan, L., Koppel, P. “Integrative Approaches to Pain Management: Expanding Our Nursing Toolbox.” Conley, S. “Cancer Nursing Hot Topics: Learning from Member Integrative Nursing Consortium of Boston. October 2018. Discussions” – Central Line Issues. Oncology Nursing Society Boston, MA. 43rd Annual Congress, May 17-20 2018, Washington D.C. Knoerl, R., Berry, D.L. “Exploring the Efficacy of an Electronic Whitehouse, C. “Getting Through Your DNP.” MGH-IHP, Symptom Assessment and Self-Care Intervention to Improve September 2018. Boston, MA. Physical Function in Individuals Receiving Taxane and Platinum- Based Chemotherapy.” Oncology Nursing Society Congress. Legor, K. “International Research Exchange - Perspectives May 2018. Washington, DC. from a UK Study Visit Experience.” International Association of Clinical Research Nurses 10th Anniversary Conference, October Reville, B. “Talking about Serious Illness.” Practical Aspects of 15-17 2018. Arlington, Virginia. Palliative Care. September 2018. Boston, MA. Podium Reville, B. “Communication about Advanced Care Planning.” Art and Science of Palliative Care Nursing. June 2018. Boston, MA. Ehrlich, O., Walker, R.K. “Patient-Nurse-Caregiver Social Processes and Management of Pain in Home Hospice.” Oncology Scott, N. “Engaging Providers from the Start.” Harvard Medical Nursing Society Congress. May 2018. Washington, DC. School-Dana-Farber Clinical Skills Course Partnership. June 2018. Boston, MA. Nursing and Patient Care Services Executive Committee Anne H. Gross, PhD, Janet Bagley, MS, Angela Creta, DNP, RN, NEA-BC, FAAN RN, AOCNS, NEA-BC RN-BC, CNL, NE-BC Senior Vice President Associate Chief Nurse, Executive Director, for Patient Care Adult Oncology Center for Clinical Services and Chief and Professional Nursing Officer Development Alexandra Mary Poyner Reed McKeever, MBA PhD, CNRN, ANP, Director, Business NEA-BC Administration Associate Chief Nurse, Pediatric Oncology 32 NURSING and PATIENT CARE SERVICES: ACCOMPLISHMENTS

Scott, N. “Paving the Way to Healthcare Access.” University of Gurschick, L., McDermott, K. “Establishing nursing roles in Massachusetts Medical School. June 2018. Marlborough, MA. an Immune Effector Cell (IEC) program to ensure safe patient passage.” Oncology Nursing Society Congress. May 2018. Tawa, M. “Can you Recognize the Common Skin Cancers: Washington, DC. Overview of Cutaneous Oncology.” American Academy of Nurse Practitioners National Conference. June 2018. Denver, CO. Magni, K. “Are We Good to Go? Can We Do Better?” American Society of Clinical Oncology. September 2018. Phoenix, AZ. Tawa, M. McCann, S. “Cutaneous Lymphomas: Intersecting Clinical Care and Community.” Dermatology Nurses’ Association Mazeika, T., Conley, S., Aikey, S., Buckley, P., Coughlin, M., Annual Convention. February 2018. San Diego, CA. Hilton, N. “Development and Implementation of an Evidence- Based Practice Venous Assessment Tool to Improve Patient Tawa, M. McCann, S. “Holistic Care and Sharing Good Practice.” Outcomes During Chemotherapy Administration.” Oncology Cutaneous Lymphoma International Nursing Network, EORTC Nursing Society Congress. May 2018. Washington, DC. CLTF Meeting. October 2017. London. McDermott, K. “Chimeric Antigen Receptor T Cell Treatment Posters for Aggressive, Refractory Non-Hodgkin Lymphomas: Nursing Implications of the ZUMA-1 Trial of Axicabtagene Ciloleucel.” Amweg, L. “Engaging Patients and Clinicians to Develop a Web- Oncology Nursing Society Congress. May 2018. Washington, DC. Based Intervention for Survivors of Hodgkin Disease.” Oncology Nursing Society Congress. May 2018. Washington, DC. Robinson, K. “Factors Associated with Genetic Testing for Hereditary Breast and Ovarian Cancer Syndrome (HBOC): An Berry, D. “The Experience of Young Women Living with Advanced Integrative Review.” Oncology Nursing Society Congress. May Breast Cancer: A Hermeneutic Phenomenological Study.” 2018. Washington, DC. Oncology Nursing Society Congress. May 2018. Washington, DC. Stephenson, S. “Ibruntinib for Steroid Refractory Chronic Graft Conley, S., Salehi, E. Underhill, M. “Improving Outcomes for vs Host Disease.” Oncology Nursing Society Congress. May Chemotherapy Induced Alopecia: Implementation of a Scalp 2018. Washington, DC. Cooling Service with FDA Approved Devices.” Oncology Nursing Society Congress. May 2018. Washington, DC. Underhill, M. “Psychosocial Outcomes of Individuals with Inherited Pancreatic Cancer Risk.” Oncology Nursing Society DeAngelis, C. “Improved Utilization of Infusion Room Chairs.” Congress. May 2018. Washington, DC. Oncology Nursing Society Congress. May 2018. Washington, DC. Engel, L. “Subcutaneously Administered Leuprolide Acetate Consistently Achieved and Maintained Low T Suppression and Nadir T Levels ≤5NG/DL Regardless of Age and Weight.” Oncology Nursing Society Congress. May 2018. Washington, DC. Emma Dann, DNP, Nancy Hilton, Kristen Legor, RN, OCN, NEA-BC BS, RN, MS BSN, RN, OCN, JD Associate Chief Associate Chief Associate Chief Nurse, Network Nurse, Adult Nurse, Research Oncology Sara Smith, MBA Senior Project Deborah Toffler, Meghan Manager MSW, LCSW Underhill-Blazey, Senior Director, PhD, APRN, AOCN Patient Care Services Interim Director, Phyllis F. Cantor Center for Research in Nursing and Patient Care Services www.dana-farber.org/nursing 33

www.dana-farber.org/nursing 450 Brookline Ave., Boston, MA 02215-5450 Nursing Annual Report Editorial Board Mary K. Murray Administrative Specialist, Center for Clinical and Professional Gillian Buckley Development Associate Director, Content & Creative Services, Communications Sam Ogden Angela Creta, DNP, RN-BC, CNL, NE-BC Photographer, Communications Executive Director, Center for Clinical and Professional Development Renee Siegel, MSW, LCSW Program Manager, Patient and Family Advisory Councils, Deanna Finlayson Volunteer Services and Programs Graphic Designer, Communications Sara Smith, MBA Naomi Funkhouser Senior Project Manager, Nursing and Patient Care Services Manager, Content & Creative Services, Communications Lee Whale Kara Garfield, MPA Associate Art Director, Communications Program Manager, Nursing and Patient Care Services Anne H. Gross, PhD, RN, NEA-BC, FAAN Senior Vice President for Patient Care Services and Chief Nursing Officer