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As frontline caregivers, Kaiser Permanente nurses play a vital role in protecting the health of our patients and communities. Getting the annual flu shot is one of the simplest and most effective ways to reduce the spread of influenza — especially among our most vulnerable patients. The flu can lead to serious complications, hospitalizations, and even death, particularly for older adults, young children, and those with chronic conditions. By getting vaccinated, nurses not only safeguard their own health but also help prevent outbreaks in clinical settings where patients trust us to keep them safe. See why four of our nursing colleagues chose to get the annual flu shot.

Congratulations to Kaiser Permanente's newest DAISY Award honorees! The DAISY Award is a way for patients and their families, along with co-workers and volunteers, to recognize the extraordinary effort and compassion that our nurses display every day. Kaiser Permanente is a national DAISY Award hospital partner, and regularly recognizes nurses, nurse leaders and teams who meet the award criteria. DAISY Nurse

“I’m ready to contribute with energy, purpose, and a collaborative spirit,” said Daniel Ramberger, DNP, RN, NEA-BC, of his recent election to the board of the Association of California Nurse Leaders (ACNL), a statewide organization dedicated to developing and inspiring nurse leaders. Ramberger, who serves as the Chief Nurse Executive at the Kaiser Permanente Redwood City Medical Center, sees his role as an opportunity to elevate the profile of Kaiser Permanente nursing as a thought leader in professional nursing leadership, Magnet designation, and workforce well-being. He also hopes his work on the ACNL board will impact Kaiser Permanente by bringing statewide insights, best practices, and innovative leadership strategies back to our organization. “Ultimately, I want to contribute to shaping programs, partnerships, and initiatives that make nursing leadership more sustainable, more human-centered, and more impactful for the communities we serve,” he noted. Ramberger is among several nurses and leaders across the organization who lend their leadership, knowledge, and expertise to professional and community boards. Engagement on boards is a great way for Kaiser Permanente nurses to expand their networks, enhance practice, and elevate nursing excellence, he said. “It ensures our teams are aligned with emerging trends, leadership development programs, and advocacy efforts that strengthen nursing practice and improve patient outcomes.”

“We were looking for new approaches to how we care for our patients to improve the overall care experience,” said Esperanza Chavez, MSA, BSN, RN, chief nursing executive at the Sacramento Medical Center. This resulted in assistant nurse manager Mary Jane Q. Cruz, RN, BSN, and a team of nurse colleagues designing and introducing a new patient care program they named the "Because You Matter: KP HUGS" program. An evidence-based practice project, "The Because You Matter: KP HUGS program focuses on promoting compassionate care, improving nurse-patient communication, and increasing the overall responsiveness to individual patient needs to boost their care experience," said Maria G. Gonzalez, RN, nurse manager, 1 West Telemetry Unit, Sacramento Medical Center. “The project was a group effort,” explained Gonzalez. "Leadership researched the current patient care experience and developed the initial HUGS objectives, but it was our staff who truly brought it to life by educating fellow nurses about the elements of the program with banners, posters, activities, and presentations — embracing the opportunity to improve how they approached patient care.” HUGS in action HUGS is an acronym for the goals the program represents: Honoring Your Commitment, Understanding Patients’ Needs, Getting to Know the Patient, and Supporting the Nursing Practice Model. The HUGS program includes: Making a personal connection: Nurses and staff engage with patients through empathy, active listening, and respect for individual backgrounds and beliefs. “We want to foster care where we see our patients as a whole person — not a room number or diagnosis,” said Chavez. "We value their stories, personal needs and preferences to build trust and foster a healing environment." "For example, a patient shared her love for candles with one of her nurses, so the following day, the nurse brought in a battery-operated candle for the patient’s comfort,” said Chavez. Communication matters: The HUGS program focuses on nurses being more intentional about getting to know their patients and their patients’ families better. "Our rounding now goes beyond simply checking on patients," said Gonzalez. "We ask purposeful questions, such as ‘What matters to you?’ to show empathy and connect on a deeper level. This builds trust and strengthens the bond between patients and their care teams.” Patient-centered care: Nurses partner with colleagues to create a care environment where the patient is at the center of their experience. For example, the team introduced a no-pass zone, where any care team member has permission to stop in a patient's room when their call light is activated, ensuring immediate patient care. “Lastly, the HUGS program underscores the importance of the nurse practice model, which consists of six core principles: professionalism, compassion, teamwork, patient- and family-centered care, excellence, and integrity," said Cruz. "I encourage every nurse at the Sacramento Medical Center to embody and demonstrate these values in every interaction with every patient, every day.” Benefits of HUGS “After five months of implementing the Because You Matter: KP HUGS program, the 1 West Telemetry Unit saw a 12% increase in their care experience scores," said Cruz…

Congratulations to Kaiser Permanente's newest DAISY Award honorees! The DAISY Award is a way for patients and their families, along with co-workers and volunteers, to recognize the extraordinary effort and compassion that our nurses display every day. Kaiser Permanente is a national DAISY Award hospital partner, and regularly recognizes nurses, nurse leaders and teams who meet the award criteria. Daisy Nurse

Llewelyn “Lulu” Lagmay has been a nurse for 14 years, but she still remembers the mentor she had early in her career. “I had a mentor who made a lasting impact on me — someone who gave generously of their time and guidance,” said Lagmay, BSN, RN, staff nurse in the Intensive Care Unit at Kaiser Permanente San Leandro. “Becoming a preceptor has been my way of paying that forward.” Lagmay is among the more than 1,200 experienced registered nurses in Northern California who support new graduates and nurse fellows as mentors, or preceptors. They provide mentorship, knowledge, and support to new graduates and nurse fellows transitioning their practice as part of Kaiser Permanente’s nurse residency and fellowship programs.  The mentors act as educators, role models, and a resource, fostering a supportive learning environment while ensuring patient safety. “There’s something incredibly fulfilling about seeing them gain independence, step into their roles, and become strong, trusted team players,” said Lagmay.  “Knowing I had a hand in that transformation is why I keep doing it.” Benson Yeung, DNP, RN, Northern California director of practice excellence, calls nurse preceptors “the heart of our nurse training programs.” Yeung said it goes beyond training — the preceptor-resident relationship strengthens the nursing community and ultimately elevates patient care. Nurse preceptors played a crucial role in earning the highly sought-after Practice Transition Accreditation Program accreditation from the American Nurses Credentialing Center for nurse residency and fellowship programs. “They have created an environment where new nurses feel empowered, supported, and confident as they transition into their new role,” Yeung said. Mutually beneficial relationship Lagmay shares that her role isn’t just about teaching, but also an opportunity for her professional growth. “Mentoring sharpens my practice and challenges me to reflect, adapt, and stay current,” she said. “Every new nurse brings a fresh perspective, and sometimes that opens my eyes to different ways of doing things. Their questions or observations can highlight opportunities in our systems and workflows that might otherwise go unnoticed.” Josephine Igbineweka, RN, transitioned from a medical surgical unit to the San Leandro ICU as a nurse resident, where she worked with Lagmay and another preceptor. She credits them for easing her fears and boosting her confidence in her critical care practice. “They have been incredibly supportive of my learning, invested in my success and growth, and generous in their leadership and mentorship,” said Igbineweka. “Their commitment to excellent care has inspired me to improve and be the best nurse I can be.”

When an 82-year-old woman with multiple chronic conditions arrived at the Kaiser Permanente Santa Clara Emergency Department (ED) after a fall at home, she was quickly triaged by a nurse trained in geriatric screening and assessment protocols. When evaluating the woman, the nurse used what is called the “5Ms framework.” That framework guides staff to address all aspects of an older adult's health and well-being. The 5Ms stand for mobility, mind (cognition and mental health), medications, multicomplexity, (complex medical conditions), and what matters most.  The nurse uncovered that the Santa Clara patient lives alone and didn’t eat or drink enough, which contributed to her fall. “The tailored assessment helped staff to identify not only her physical fall injuries but contributing health challenges common among older adults, including dehydration and medication mismanagement,” said Hazel Aspiras, MSN, RN, Santa Clara’s emergency department manager. A multidisciplinary team — including a nurse, physician, social worker, and patient care coordinator — collaborated to build a comprehensive care plan, ensuring the 82-year-old patient received appropriate treatment, medication review, and fall prevention support. These age-specific tools are central to the department’s commitment to provide top-notch care for the growing population of people – and patients – who are 65 and older. By 2050, the number of Americans who are 65 and older is likely to increase from about 58 million to 82 million, a 47% jump, the Census Bureau projected in 2023. These tools also reflect why the department received an accreditation for geriatric care. To receive accreditation, the department met a higher quality of care by educating staff, making physical environments geriatric friendly, and establishing quality measures, for example. “This holistic approach exemplifies the value of Geriatric Emergency Department Accreditation,” said Aspiras. “This accreditation ensures older adults receive tailored, high-quality care that meets their unique needs.” Earning accreditation across the region In May, Santa Clara became the latest Kaiser Permanente Northern California ED to earn Level 2 Geriatric Emergency Department Accreditation (GEDA), a national recognition for emergency care specifically designed for older adults. With Santa Clara’s recent accreditation, 10 Northern California emergency departments have now earned the prestigious designation, including Antioch, Fremont, San Francisco,  San Leandro, Santa Rosa, South San Francisco, Redwood City, Vacaville, and Walnut Creek. “The accreditation highlights the focus practices and interventions that support Kaiser Permanente’s model of care for older adults,” said The Permanente Medical Group Regional Director Tracy Broce, DNP, RN. “The ultimate goal is to have all EDs across the region apply for and receive GEDA.” Nurses played a pivotal role in achieving GEDA. A nursing work group led self-assessment, identified opportunities for improvement, and helped champion new workflows and training focused on older adult care. Work group champions audited charts to verify geriatric protocols were being followed, shared best practices, and care coordination among nursing, physicians, and social work—ensuring the protocols were embedded into daily practice. “By addressing both the immediate needs and the underlying health risks facing older adults, we’re improving outcomes and reducing the risk of readmissions,” Aspiras…

Postpartum hemorrhage (PPH) is a serious condition defined by excessive bleeding of the birthing patient after childbirth, resulting in blood loss of 1 liter or more. PPH is the second leading cause of pregnancy-related deaths, according to the California Department of Public Health. “We knew we wanted to reduce the chance of hemorrhage with postpartum patients. It’s one thing to hear the numbers, and it is another thing to see the impact hemorrhages have on our patients,” said Hannah Fox, RN, perinatal quality nurse consultant, Kaiser Permanente San Francisco (KPSF). Seeing the impact of PPH cases at the KPSF Medical Center, the Perinatal Patient Safety Committee & Quality Department is focused on initiatives to reduce PPH rates, especially among patients who undergo cesarean deliveries. The team recently shared this evidence-based project at the Research and Innovation Academy conference to highlight how they are implementing new procedures and processes to reduce the hemorrhage rate and its effects. Focused efforts and teamwork “By fostering strong teamwork and promoting timely interventions, our team has significantly improved outcomes, reduced mortality and morbidity, and enhanced care quality for birthing people,” said Jessi Ford, MBA, BSN, RN, RNC-OB, maternal child health nursing director, KPSF. KPSF’s approach includes structured checklists, team huddles, staff education, and regular simulations to prepare for real-world scenarios. For example, to help reduce PPH rates, the committee included the use of a secondary intravenous (IV) line on the checklists. “The use of a second IV line helps patients who experience a hemorrhage and need additional fluids,” said Nancy Rivera, DNP, MSN, CNS, RN, perinatal clinical nurse specialist, KPSF. Routine audits of the checklists help track performance and identify opportunities for ongoing improvement. “It’s inspiring to know that our strategies and tools are making a real difference,” states Rivera. “They allow us to focus on sustainability and future success.” A key part of this success is prioritizing the voices of frontline nurses. Their insights help proactively find risks and implement preventive strategies before a hemorrhage occurs. Impact and outlook Within one year, KPSF’s PPH rate dropped by 2.3%. “To see the drive and change to reduce our hemorrhage rates is rewarding,” said Fox. “Every percentage point drop means we’ve successfully prevented a patient from experiencing a hemorrhage,” she concluded.

Congratulations to Kaiser Permanente's newest DAISY Award honorees! The DAISY Award is a way for patients and their families, along with co-workers and volunteers, to recognize the extraordinary effort and compassion that our nurses display every day. Kaiser Permanente is a national DAISY Award hospital partner, and regularly recognizes nurses, nurse leaders and teams who meet the award criteria. Daisy Nurse

“Patients under our care can expect excellence from knowledgeable and compassionate nurses,” said Ace Delos Santos, BSN, RN-BC, pictured above with Yasmeen Ilyas, RN. For over a year, Delos Santos, chair of the 5th floor Unit Practice Council at the Kaiser Permanente Sacramento Hospital led a special task force to capture 31 exemplars, or best practices and quality initiative outcomes, from the medical-surgical unit. Their goal was to earn the PRISM award, which stands for Premier Recognition In the Specialty of Med-Surg, a national acknowledgment of exemplary performance and leadership in medical-surgical nursing by the Academy of Medical-Surgical Nurses (AMSN) and the Medical-Surgical Nursing Certification Board (MSNCB). Their work paid off. On June 10, 2025, dozens of nurses gathered with Delos Santos and Chief Nurse Executive Esperanza Chavez, MSA, BSN, RN for a call with AMSN and MSNCB representatives to learn they received the award – and were the first Kaiser Permanente to achieve the honor. “This award is a testament to the dedication and passion of our nurses, who keep our patients at the heart of all they do,” said Chavez. On the call, AMSN National President Kristi Reguin-Hartman, DNP, APRN, ACNS-BC highlighted standout initiatives led by Sacramento nurses that improved patient satisfaction scores and length of stay, staffing practices based on patient acuity, and the professional development of nurses through national board certification, advanced degree programs and tuition reimbursement. “Our commitment to excellence is centered around our professional practice, and growing our team to deliver the best care,” said Chavez. Another initiative highlighted was the reduction of falls with injuries, including the early identification of patients most at risk of falling, mitigation plans, and patient education. “The hard work we do allows our patients to go home faster to be with their family,” said Delos Santos. “The nursing team focus is on the patient and evidence-based practice, and it shows,” Senior Vice President and Area Manager Jay Robinson, PsyD, MBA, said on the call. “They are delivering on the promise to provide the best care for our patients and members.”