Coordinating Council
Chair: Kristina Sims, BSN, RN, CNOR
2025 accomplishments
1. Completed the 9-month Crucial Conversations Book Series for all professional governance members.
2. Updated IMPACT ByLaws using shared-decision with council members and Advisors input and updated final copy to website for access and transparency.
3. Coordinated Nurses Week Faire, summer picnic, and Annual IMPACT Consortium to disseminate the work that showcases the culture of nursing excellence.
Research and Evidence Based Practice Council
Chair: Lucas Tonies, BSN, RN, CCRN
Chair-Elect: Perla Santillan, MSN, RN, CCM
2025 accomplishments
1. Initiated ten diverse EBP/QI/Research projects to improve patient outcomes and expand medical knowledge.
2. Encouraged engagement in the evidence-based training programs to enhance nurses’ critical thinking and practical skills.
3. Showcased interactive booth at Nurses Week Fair to promote research engagement and evidence-based care.
Quality & Safety Council
Chair: Lois Chen, BSN, RN, CCRN
Chair-Elect: Reichel Dizon, BSN, RN
2025 accomplishments
1. The team continued strengthening the ability to interpret and share their unit-specific quality metrics to guide performance improvement (PI) decisions.
2. Develop and use A3s as an effective problem-solving tool, helping to clarify problems, analyze root causes, then design and test solutions, and drive meaningful learning for quality metrics specific to the units.
3. Developed a SMART goal to reduced C.Diff cases from 10 (2024) to 7 (2025) and plan to replicate similar project strategies for 2026 to improve pain assessment adherence.
Education, Practice & Informatics Council
Chair: Violeta Luna-Jones, BSN, RN
Chair-Elect: Kelsey Curtis, BSN, RN, CNOR
2025 accomplishments
1. Reeducated for dissemination the multiple uses of ROVER.
2. ANA 2025 Nursing Code of Ethics focus each month and tie into nursing practice.
3. Planned and ensured CIS crossover was supported in each unit with an individualized education board.
Professional Growth, Development & Consumer Experience Council
Chair: Maria Santos, BSN, RN
Chair-Elect: Jennifer Quinico, BSN, RN
2025 accomplishments
1. Finalized and launched the Standardized Employee of the Month Template for all units.
2. Goal to increase number of DAISY & PETAL nominations by ensuring signage in each room in hospital.
3. Goal to increase number of certified nurses and clinical ladder information by making of a video for “Certified Nurses Day”.
4th Floor Unit Council
Chair: Desiree Toledo, MSN, RN
2025 accomplishments
1.Strict adherence to the C-diff algorithm – 446 C-diff free days!
2. Checking skin bundles, turning and repositioning our total care patients every 2 hours; use of TURN CLOCK – 422 HAPI free days!
3. Final Sweep Project– rounding on patients 30 minutes before every shift change addressing 5Ps: potty, positioning, pain, personal belongings, pump – to reduce call lights at shift change.
5th Floor Unit Council
Chair: Janice Laccay, BSN, RN
2025 accomplishments
1.We met and exceeded the “Likelihood to Recommend” Unit Target and Hospital Target for 2025.
2. Night shift achieved 100% in pain assessment and reassessment.
3. An increased engagement in attendance to a variety of conferences such as the 50th Annual ONS Congress, WOCNext, AMSN Convention and the ANCC Magnet & Pathway Conference.
ICU Unit Council
Chair: Christina Omori, BSN, RN, CCRN
2025 accomplishments
1. Break Relief/Critical Care Transport RN Role Expansion communication project.
2. Unit Workflow Improvements to Prevent Patient Harm: Daily Pictures for Patients with Braden </= 18, Lucas Device checklist to ensure readiness during emergent situations.
3. Multipurpose room Committee and Project Boards Revamp: Ensure transparency and dissemination of information to all unit staff members.
NICU Unit Council
Chair: Alexis McLaughlin, BSN, RN, RNC-NIC
2025 accomplishments
1. Put into practice a new IV infusion set to improve efficiency, time management and patient safety.
2. Partnered with Care Experience leader to advocate for a place of respite and community building for our NICU families.
3. Provided Bottle Sterilization for all patients that are bottle feeding, through suggestions from our NICU Parent Survey.
Labor & Delivery Unit Council
Chair: Marie Garcia, MSN, RN, RNC-OB
2025 accomplishments
1. Aromatherapy Project – Help with laboring patients experiencing anxiousness or nausea
2. Chorioamnionitis Project – Reduce rates of infection
3. Circulator Checklist – Help staff nurses be more comfortable circulating in OR
OR Unit Council
Chair: Stephanie Gambino, BSN, RN
2025 accomplishments
1. Planned and launched the OR RN to RN Handoff tool
2. SSI Bundle Fallout Review
3. SSI Prevention Team Drill Downs
PACU Unit Council
Chair: Arlene Pascual, BSN, RN
2025 accomplishments
1. Surgery Passport – created a healthstream module and provided teaching to 4th floor education day to prevent delays in procedures due to incomplete preoperative information.
2. Aromatherapy EBP project – completed in May 2025 and preliminary findings show overall preoperative anxiety was reduced due and now offered to all preoperative patients. Planning to disseminate final results through internal professional governance structure and external conferences.
3. Postoperative Teachback SSI Quality Improvement Project – PACU nurses were podium presenters at May’s KP RIA conference sharing the decrease and 0 surgical site infection following implementation.
ED Unit Council
Chair: Rachel Whyte, BSN, RN, CEN
2025 accomplishments
1. Pedi Asthma project – review and implement workflow to ensure timely interventions.
2. Organized and launched a unit staff recognition award honoring colleague “Chee Hseish ED All-Star”.
3. Launched, educated, and led colleagues on how to request and submit peer feedback for over 112 ED nurses.
PCCM Unit Council
Chair: Julie Vasquez, BSN, RN, PHN
2025 accomplishments
1. Manager Escalations Workflow project – reduced response time from 1hour to 1 minute.
2. AB1203 Project – monthly average was 77% and increased to 100% post implementation.
3. Worked with managers by creating a manager email template to share a clear and transparent Annual Review process that increased peer feedback and gave support resources for professional development such as nursing certifications.
GI/IR Unit Council
Chair: Bethany Eytchison-fung, RN – IR
Member: Nowal Rashid, MSN, RN, PHN – GI
1. IR team improved patient communication workflow to reduce same-day cancellations and patient access to urgent care.
2. IR involved interdisciplinary team in shared-decision process of trialing and reviewing effectiveness of multiple patient securement devices for IR table to choose final device.
3. GI team launched peer feedback to all nurses in department and rolled out recognition programs Employee of the month and the DAISY & PETAL awareness.
4. GI team developed a process flow chart to standardize lab specimen collection.