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“I wish I had a list of everything you needed so I didn’t have to keep going in and out of the patient room.”  What San Leandro ICU nurse manager, Sandi Kaur, MSN, RN, said as a light joke to her physician colleague, Jasper Ip, MD, instead became a light bulb moment.  Now known to ICU care team members as the Procedural Optimization Project, communication has improved in preparation for procedures such as bronchoscopy, percutaneous tracheostomy, line placement, chest tube placement, and paracentesis because of Kaur’s informal comment. Each procedure has a workflow outlining specific details for the ordering physician such as a list of supplies and preferred patient positioning.   The order also includes a procedure time, which allows nurses to prep everything in advance. “Just like you would see in the operating room or interventional radiology, everything is in place in the room, and the patient is prepped and ready before the doctor arrives,” said Kaur.   “It takes away all the guess work and is especially helpful for nurses who might not be as familiar with the process,” said Llewlyn Lagmay, BSN, RN, CCRN, Staff Nurse III.    “Efficient is the best way to describe it. Bedside and procedural nurses know what to expect and can plan their day accordingly, and similarly our physician partners can manage multiple procedures a day while balancing their clinical duties – and it’s all seamless for the patient,” added Kaur.    Additionally, the new process minimizes deviations in standard practice and improves patient care. “When procedures are done more efficiently, it’s less stress and discomfort to the patient,” added Lagmay.  Consistency of practice between providers improves safety as well as quality. To ensure all nurses are familiar with the new process, a special procedural optimization station is set up on skills day, so all nurses are familiar with the process, as well as receiving one-on-one education.  

The inaugural Northern California Nursing Research and Innovation Conference on May 14 and 15 2024, was a resounding success, bringing together over fifty research and evidence‑based practice (EBP) posters from enthusiastic and dedicated nurses – some of whom were presenting for the very first time. The two‑day event was a vibrant showcase of nurse‑driven initiatives, reinforcing Kaiser Permanente’s commitment to excellence in nursing practice and patient care. Keynote speakers set the tone for the conference, with Dan Weberg, PhD, MHI, RN, FAAN discussing the future of AI in nursing and Erica Hooper, DNP, RN, CNS, CNL, PHN and Rayne Soriano, Ph.D., RN, NE‑BC emphasizing the importance of Caring Science within our Professional Practice Model. The conference was a platform for recognizing outstanding work. Toby Marsh, MSN, RN, FACHE, NEA-BC, NCAL Regional Chief Nurse Executive and Vice President of Clinical Integration, captured the spirit of the event perfectly, stating, “The future is really bright. This is the best time to be a Kaiser Permanente nurse and nurse leader in Northern California.” One of the standout moments was the Most Innovative Poster Award given to a team from the Antioch Medical Center. Mhagsy Celestino, MSN, CCRN, RN, RNM, proudly stated, “The Most Innovative Poster Award is dedicated to my wonderful CAUTI TeamChampions for their impeccable dedication and monitoring for success in promoting quality and safe care for our members.” The Santa Clara Medical Center team led by Chief Nurse Executive, Stacy Alves, DNP, MS, RN, NEA‑BC, was recognized for the most abstract and poster submissions with 14 shared at the conference. The team from the Modesto Medical Center, led by interim Chief Nurse Executive, Betty Lopez, DNP, MPA, RN received the award for best poster design for their work improving the pediatric patient experience. Dynamic and inspirational aptly describe the Research and Innovation Academy Conference. It was an opportunity for nurses to cross-pollinate best practices, challenge the status quo, and embrace a spirit of inquiry. As we continue to elevate nursing practice, we are reminded of the importance of caring for ourselves and our colleagues to provide the best care for our patients. The event also featured golden nuggets of knowledge on abstract preparation and becoming a peer reviewer for professional journals. Congratulations to all the award recipients and participants for their exceptional contributions. Your dedication and innovation make Kaiser Permanente Northern California the best place to work and receive care. We look forward to continuing this journey of excellence and innovation together. This conference was a testament to the power of collaboration and the relentless pursuit of excellence in nursing. A special thank you to Ifeoma Nnaji, DNP, RN, NI-BC, NPD-BC, NE-BC, FACHE for her exceptional leadership of the KP Nurse Scholars Research and Innovations Academy. Her dedication and guidance have been instrumental in fostering a culture of research and innovation within our nursing community

“Bernice is an embodiment of the Kaiser Permanente mission. Even with her ever-increasing responsibilities, she never backs away from rolling up her sleeves to help lend a hand on the floor, or making time to mentor and guide us, while also leading the various committees she is a part of,” said Tseganesh Tamrat, RN, staff nurse II, medical surgical, San Jose Medical Center. Bernice Yale, BSN, RN is the San Jose nurse manager of the medical surgical unit and was named as a 2024 Kaiser Foundation Hospitals Nurse Leader of the Year. She has been with Kaiser Permanente for 26 years. Inspiration for Nursing Bernice was inspired to become a nurse after admiring all the hard work that her mother did as a Licensed Vocational Nurse. “I became a caregiver at the age of 13 for my neighbor who lived down the street. She was disabled and eventually became dependent on a ventilator,” said Yale. “I learned how to not only be like a certified nursing assistant type of caregiver, but also how to advocate for her. As I saw how physical therapists and nurses came and took care of her, and that also inspired me to become a nurse.” Now, her team inspires her. “They lift me up – if I ask them for things, they say, we'll do it for you. We share a vision of having a unit that is well-run, clean, with so many wonderful caregivers, who are really passionate about what they do,” she shared. Leading with Purpose “I like to lead with passion. When I come to work, I show up for work, ready to do the best job that I can,” said Yale. “I like to hire a team that is caring and compassionate and not task oriented. Clinical expertise is important to me. However, the way we bond with our patients is also important, and I'd like to lead with care and show that I care for my team so that they can care for their patients.” “She never talks at us, rather she converses with us, involves us in decision making and leads by example,” added Tamrat. “Through her actions reminds us that every patient on the unit is the responsibility of every nurse she constantly creates a safe work environment for everyone. Delivering Care Excellence Bernice shares that extraordinary nursing means that you give it your all. “You show up to take care of that patient who is number one. You not only taken care of the patient, but you might also be taking care of the family and handling whatever concerns that they have because they're ultimately going to be bringing that patient home.”

Geriatric patients being cared for at the Roseville Medical Center are in trusted hands according to Narlyn Llamas MBA, MSN, RN, GERO-BC, Nursing Professional Development Specialist and NICHE Coordinator. “We made a concerted effort to launch and support NICHE, or Nurses Improving Care for Healthsystems Elders in 2020,” said Llamas. “We encouraged staff to become Geriatric Resource Nurses (GRNs), resulting in 120 nurses graduating from the program in just a few years.” "They are now champions on all our units,” explained Llamas. “Our GRNs take a leadership role to educate co-workers about the unique challenges and risks this patient population faces, identify gaps in units, and promote change in practice to improve patient care and safety.” Through their specialty training, GRNs provide more care to the over 65-year-old inpatient population and are fully knowledgeable about a wide range of geriatric syndromes such as depression, delirium, malnutrition, frailty, falls, and pressure ulcers. Becoming a GRN is also a steppingstone toward obtaining Gerontological Nursing Certification (GERO-BC). With the support of the Regional Patient Care Services and Nurse Scholars Academy, the Professional Development Council of Roseville’s Voice of Nursing led by Summer Malepeai, RN, GRN and Llamas, a GERO-BC review course for nurses was organized to help prep for the exam. Fifteen NCAL hospitals participated with a total of 171 nurses attending the course, of which 45 were from Roseville. Since the start of NICHE, there are now eight GERO-BCs in Roseville, and more are becoming certified. “Nurse engagement on this journey has been incredible — and is propelling us to new heights,” said Gertrude M. Tiangco-Alba, MSA, RN, Roseville’s Associate Chief Nurse Executive. At the end of 2023, the Roseville hospital was recognized as an Age-Friendly Health System Participant by the Institute for Healthcare Improvement (IHI). The GRNs were inspired to pursue this recognition for Roseville after attending the NICHE conference in April 2023. The recognition validated the 4Ms framework that is integrated in the care of the older adults. In 2024, the team of GRNs is working towards the second and highest level of the Age-Friendly Health System recognition which is called Committed to Care Excellence.

“There is always a chance we could have an emergency situation where a baby is unexpectedly born at our facility, so we need to be prepared,” explained Barbara Lee Urnes, BSN, RN, Emergency Department Staff Nurse IV at the Fremont Medical Center, where services for labor and delivery, neonatal care, and pediatrics are handled at their sister-facility in San Leandro. “I knew the perfect person to help me prepare for such an emergency,” added Urnes. “I was able to turn to San Leandro NICU nurse Heather Wynne, BSN, RN, who also happens to be my daughter, to assist me in identifying the most up-to-date equipment and supplies needed to revamp the Fremont Emergency Department Neonatal Resuscitation Bag, and the associated protocols to support our Emergency Department in using the new equipment.” Incorporating insights into current practices and newer supplies, together the mother-daughter team created an updated list of equipment and streamlined documentation to ensure the resuscitation bag is checked regularly and restocked as items expire.  “We talk work stuff all the time, but it was nice to share knowledge from the NICU, and support the Fremont ED team,” said Wynne. “This partnership between Barbara and Heather demonstrates qualities of a highly reliable organization — especially between sister facilities who provide seamless care to our members in the GSAA,” said Christopher Neilson, MHA, BSN, RN, NE-BC, Fremont’s Chief Nurse Executive/Chief Operating Officer. “Their efforts ensure that we are prepared in the event of a neonatal emergency.”

Mary Briones-Gomez, MSN, RN, CHPN, was awarded the 2024 Extraordinary Nurse Award – Continuum Leader of the Year. She is the Supportive Care Services Department Manager in the Greater Southern Alameda Area and has worked for Kaiser Permanente since 1998. In her role, she manages the palliative care team of nurse practitioners, registered nurses, medical social workers, and an administrative staff member.  Prior to her leadership role, Mary was an advice nurse for continuing care, a case manager, and clinical practice consultant in palliative care. “Mary is the ideal manager," her team said in the Extraordinary Nurse Award nomination for Briones-Gomez. "She leads by example with kindness, understanding, flexibility, humor, and transparency.” Inspiration for Nursing “I come from a family of nurses, and they inspired me growing up – seeing these strong, intelligent women who loved making a difference in patients' lives while also taking care of their families,” said Briones-Gomez. “I was always drawn to an occupation where I could help and serve the public.” Leading with Purpose “I lead with purpose by being accountable, advocating for my patients and team, providing access to care for seriously ill patients – many at the end of their lives – and providing knowledge to help nurture others,” said Briones-Gomez. “My purpose is to care for and support my family, patients, and my team the best I can. It brings me joy at home and at work,” added Briones-Gomez. Briones-Gomez team credits her leadership for improving employee satisfaction, as demonstrated in People Pulse scores between 2022 and 2023. “She creates a culture of celebration in the department and knows everyone's birthday, work anniversary, and acknowledges all major life milestones,” they said. Delivering Care Excellence “Extraordinary nursing to me is the dedication to providing compassionate care to support patients, families, and colleagues to make a difference every day,” said Briones-Gomez. “Additionally, my nurse colleagues are compassionate, exceptional nurses who go the extra mile to help others in their personal and professional lives,” Briones-Gomez said. “They inspire me to learn and strive to do the best job I can do every day.”

“NO Foley… No CAUTI,” was a concerted effort to eliminate Catheter-Associated Urinary Tract Infections (CAUTIs) through an evidence-based Foley Catheter Removal Protocol at the Antioch Medical Center. The initiative propelled Antioch Medical Center into the Top 5 for the lowest CAUTI rates within the Northern California region, from October 2022 to August 2023. “As nurses, we take care of patients 24/7, and this protocol was revised multiple times with constant input from our Urology Department,” said co-lead and CAUTI Champion Mhagsy Celestino, RN. “The team attributes our success to remarkable interprofessional collaboration, uniting nurses, physicians, infection preventionists, and quality experts.” Originating from an intensive quality improvement endeavor, this protocol marks a significant cultural shift towards a motivated and accountable care environment. “We even had a comprehensive protocol for monitoring, wherein once the nurses document the Foley catheter, we instantly have the computerized data and our ANMs also diligently help us monitor for success,” added Celestino. “This achievement underscores the profound impact of compassion, teamwork, and evidence-based practice on patient care.” The protocol’s success is sustained by ongoing education, creative outreach, and enduring change. “An educational ‘roadshow’ and innovative strategies, including a music video, to engage and educate nurses, resulted in significant participation and feedback. We were able to reach a lot of nurses through education and we got an 85% return rate from other services including flyers and a huddle guide we created,” said Celestino. “Antioch Medical Center’s battle against CAUTIs exemplifies the power of professional governance and collaborative initiatives in driving significant patient care improvements,” added Celestino. “This protocol grants nurses the autonomy and independence to do what’s best for our patients.”