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2 Nurses in front of a poster at a conference.

Sharing Healthy Workforce at the 46th Annual Association of California Nurse Leaders Conference 

Kaiser Permanente Fresno Critical Care Unit joined the Healthy Workforce Institute (HWI) more than five years ago to address negative behaviors that were impacting the team culture in the department. Due to the success of this program, HWI is being spread to departments throughout Patient Care Services.

The CCU Healthy Workforce – Everyday Respect project was highlighted at the 46th Annual Association of California Nurse Leaders conference earlier this year. Nursing Operations Director Bridgette Wilson, MSN, RN, and Staff Nurse III Kristen Watkins, ASN, RN presented the team’s findings and recommendations.

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Nursing research studies

Two of KP Fresno’s geriatric-certified nurse’s recently had the opportunity to present at the National American Delirium Conference in Sacramento in June. Clinical Nurse Specialist Krystal Pombo, MSN, RN, CNS, AGCNS-BC, Adult Services, and Staff Nurse III Danny Nguyen, RN, BS, Gero-BC, Telemetry, shared findings from an evidence-based performance improvement project focused on cognitive health.

“The project involved a sleep assessment of patients upon admission or each morning,” Nguyen said. “The nurses ask about their sleep, whether they got a lot, some or little. If the patient had poor sleep, there is a sleep menu the Geriatric Committee revamped that includes offering a lavender towel, eye mask, ear plugs, dimmer lights, or medication like melatonin. Lack of sleep plays a big role in delirium.”

Nguyen said that if a patient reports severe sleep deprivation, the team works with physicians to determine what else they can do to help improve sleep outcomes. Sleep deprivation can be a factor that contributes to delirium which can cause medical complications or a worsening of symptoms.

The sleep assessment project has been implemented in Med-Surg, Telemetry and Critical Care Unit.

Since this project was implemented, Pombo said patient sleep assessment completion increased from 35.3% to 95.7%. The patient-reported sleep quality improved from 76.6% to 86%.

“This work aligns with facility initiatives specific to the Senior Surgical Care Program as well as our recent recognition as a level 2 Age-Friendly Health System,” Pombo said.

For Nguyen, he was proud to represent KP Fresno and the Geriatric Committee’s work at the conference.

“It was an amazing experience and gave me a bigger picture about why we need to do the research and quality improvements in these areas to advocate for our patients,” Nguyen said. “Becoming a certified geriatric nurse gave me the opportunity to learn about our older population. This education gives me a better insight into providing individualized care, and about the age-related disease process. I’m thankful for the opportunity to learn, grow and expand my knowledge. I wanted to give back to the elders who once took care of us.”

Completed 2024 studies

Sleep Assessment
Purewick (regional CNS project)
Ultrasound-Guided IV Training

Studies in progress

Geriatric Escape Room
Improving Registered Nurse National Certification at KP-Fresno
Gamification to Enhance Staff Satisfaction
Secure-A- Cath
Geriatric Symposium
Geriatric Care Cart
CCU -Competencies-Various Teaching Strategies
End Tidal CO2 in PACU

UBC 2024 Team

Unit Based Councils engaged in Quality Improvement, Patient Safety and Care Experience

The Unit Based Council (UBC) at Kaiser Permanente Fresno represent nurses from all inpatient departments in Patient Care Services and including Utilization Management and the Emergency Department. They meet for a full day once a month to learn, problem solve, and collaborate as interprofessional teams to improve quality, safety, and care experience in our organization.

This year, the UBC teams embarked on an educational journey to incorporate the principles of High Reliability Organization (HRO) and Daily Management System (DMS) into their projects. Armed with tools such as K cards and the coaching kata these dedicated teams are making impactful changes within their departments.

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Nursing Professional Development

The Nursing Professional Development Council, a part of our shared governance structure, was developed to provide nurses with support and structural empowerment to increase clinical nurse engagement. This consists of a group of clinical nurses divided into these six subcommittees: Academic Progression, Clinical Ladder, Equity, Inclusion, and Diversity; National Certification, Research, and Rewards and Recognition. The dedicated team of nurses and nursing professional development specialist have contributed to many events this year including Nurse’s Week celebrations, Certified Nurses Day celebration, recognitions for academic progressions and clinical ladder achievements and research projects. Ongoing updates for this work can be found on the Fresno Intranet.

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Improving care for our aging population

Kaiser Permanente Fresno provides high-quality, compassionate care for its aging population. The Geriatric Committee, comprised of registered nurses from all levels of care, organized the inaugural Geriatric Symposium in 2024.

The daylong event included interactive booths to educate and bring awareness to the specialized care of the geriatric population. Nurses such as Vanessa Matcham, BSN, RN, PCCN, GERO-BC, used innovative teaching methods – like an escape room – to identify delirium prevention interventions. Booths featured a sensory station to help participants understand vision loss and tactile function and a geriatric care cart stocked with puzzles and activities that help with cognitive and emotional needs.

Geriatric Medicine Physician Lead Amit Saini, MD, Continuing Care and Extra Care Program, was the keynote speaker. Additional conference speakers included Senior Surgical Care Program Physician Lead Anna Avik, DO, Orthopedics, and Coordination of Care Service Director Katrina Hernandez, BSN, RN, Continuing Care. This event was attended by a multidisciplinary group of employees from both TPMG and KFH.

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Improving care of pediatric surgery patients

Pediatric surgery patients are a sensitive population requiring specialized care. The Post Anesthesia Care Unit (PACU) team recognized a need for enhanced pediatric education and initiated a quality improvement project to strengthen care for this population. Focused education included airway management, code blue scenarios, malignant hyperthermia, and overall post-surgical care for pediatric patients.

Anesthesia Dr. Serena Ng, MD and Head and Neck Surgery Dr. Jonathan Law, MD partnered with Nursing Professional Development Practitioner Jessica Battenburg, BSN, RN, NPD-BC, CNOR to include education in their specialties specific to pediatric care. As a result of this training, staff reported increased confidence in managing patients, improved safety and quality of care, and strengthened collaboration between nursing and physician teams.

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Supporting the future of nursing

Mentoring is a hallmark of professional practice and transformational leadership that inspires, empowers, and develops leaders at all levels of nursing. Several nurse leaders supported the future of nursing by serving as a mentor to nurses new to their practice.

The mentoring relationship between Cheryl Nassrallah, MSN, RN, OCN, NE-BC, and Chris Rooney, BSN, RN, exemplifies the power of professional mentorship in nursing leadership. With Cheryl’s extensive experience as a nurse leader spanning over a decade at Kaiser Permanente Fresno and Chris’s recent transition to Nurse Manager in the PACU, their collaboration underscores the importance of guidance and mutual growth.

The focus areas of their mentoring journey—leadership development, relationship building, constructive feedback, and cultural integration—highlight how mentorship can shape a mentee’s approach to their role while reinforcing organizational values. Chris expressed that the mentorship provided him with invaluable insights and skills, forming a solid foundation for his career trajectory within Kaiser Permanente. Cheryl reflected on the fulfillment she experienced in mentoring Chris, emphasizing the enduring value of these professional relationships even beyond formal program timelines.

Such partnerships not only strengthen individual growth but also foster a culture of continuous learning and support, which ultimately enhances the organization’s commitment to excellence in patient care. Cheryl’s openness to being a future thought partner for Chris further reflects the lasting connections that effective mentorship can create.

Mentors

Shelly Bressoud, DNP, RN
Cheryl Nassrallah, MSN, RN, OCN, NE-BC

DeAnna Ybarra, MSN, RN, CNS, RNC-NIC

Mentees

Abigail Armack, BSN, RN
Jaspreet Bhangoo, MSN, RN Gero-BC
Steven Campbell, BSN, RN
Erica Dixon, BSN, RN
Kate Garske, MSN, RN, MS-BC

Amarjit Grewal, BSN, RN MS-BC
Stevey Pope-Allred, MSN, RN
Chris Rooney, BSN, RN
Edina Williams, BSN, RN
Jennifer Wong, BSN, RN, RNC-OB

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Gurpurab celebration spreads love and kindness

On November 4, a dedicated group of Kaiser Permanente employees organized an event to celebrate Gurpurab, a festival to celebrate the birthday of Guru Nanak Dev Ji, who is the founder of Sikhism and the first Sikh Guru. As one of the organizers of the event, PCCCM Gurpreet Saran, MSN, RN believes that being able to share this celebration with other at work fosters teamwork, boosts morale and provides a platform for educating caregivers about Sikh values and traditions. At the celebration, traditional food and music was shared with the gatherers as well as pamphlets and posters, teaching others on articles of faith that caregivers may encounter. Gurpreet stated, “Understanding these cultural and religious practices is essential for providing respectful and competent care.”

Lakhdeed “Lucky” Lehal, BSN, RN, Staff Nurse II in telemetry, shared that this celebration was organized to bring awareness of the Sikh culture to others here at Kaiser Fresno and to spread the message of the first guru which is “oneness and love for all”.

Sikhism is the fifth largest religion in the work and there are over 250,000 Sikhs in California alone. Gurpurab serves as a reminder of the belief that humanity is one and everyone is equal; we should share with others; live honestly and truthfully; and fight for social justice.

“Looking ahead, my vision for this celebration is for it to continue to grow and evolve. I hope that, in future years, more staff members from various cultural backgrounds will share their traditions and heritage with us, continuing to promote cross-cultural understanding within the Kaiser community,” said Saran.

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Nurses provide stroke education at Clovis Trail Fest

Even the threat of rain couldn’t dampen the enthusiasm of volunteer nurses from Kaiser Permanente Fresno Medical Center who provided blood pressure screenings and stroke education to the community during the eighth annual Clovis Trail Fest.

Nurses engaged with walkers, runners, and cyclists to educate them about stroke warning signs and prevention tips. They even offered blood pressure checks to individuals who wanted them.

“Blood pressure is important to monitor as it is a stroke risk factor, but it’s also important for people of all ages and health ranges to be able to recognize the signs and symptoms of a stroke,” said Quality and Safety Improvement Consultant and Stroke Coordinator Tina Pierce, BSN, RN, PHN. “You never know when you or someone you love might have a stroke. Being able to recognize the symptoms is the first step to getting care as soon as possible.”

This free community event takes place along the Old Town and Dry Creek Trails in Clovis. It includes dozens of vendors with activities, snacks, and helpful information aimed at promoting a healthy lifestyle.

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Community volunteering

Nurses and doctors in the Maternal Child Health department make caring connections with their patients daily. They work together to support new moms, their partner and baby.

Sadly, there are times when patients receive news about a terminal diagnosis or experience the death of a baby. This is one of the most devastating experiences a family can go through.

Kaiser Permanente Fresno partners with the Angel Babies program offered through Hinds Hospice. Angel Babies provides support to mothers and families who have experienced an infant loss or whose unborn child has been diagnosed with a terminal condition.

In 2020, the Maternal Child Health nurses and doctors wanted to do more to help support this program and our patients.

Led by Staff Nurse IV Jennifer Wong, RN, Kaiser Permanente Fresno Maternal Child Health nurses formed the Healing Hearts team and participated in the Angel Babies Walk/Run raising over $2,500.

The spirit of community volunteerism continues to grow over the years with Healing Hearts team members coordinating bake sales, silent auctions and donations for Angel Babies. Kaiser Permanente Fresno now supports the walk/run event with a sponsorship.

This year, Healing Hearts was recognized as the top team contributor with $5,000 in donations. Led by co-captains Wong and Staff Nurse IV Geri Larson, RN, Kaiser Permanente Fresno nurses, physicians, friends, and family walked together in support of local mothers and families.

This spirit of community giving is evident through many other outreach and participation efforts in local projects or events:

  • Alzheimer’s Association – Walk to End Alzheimer’s
  • American Heart Association – Heart & Stroke Walk
  • Clovis Trail Fest – Nurses provided blood pressure screenings and stroke education
  • Court Appointed Special Advocates (CASA) – Towel donation drive for foster youth
  • Fresno County Breastfeeding Coalition – Breastfeeding Walk and Celebration
  • Holiday Fill-A-Stocking Donation Drive – Supports vulnerable seniors
  • Poverello House and Central California Food Bank – Emergency Department turkey drive
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