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Nursing Excellence

The Online Newsletter for Children's Nurses
e-Edition, Issue 12 

Empowered Nursing Professional Practice

2012 American Nurses Credentialing Center, Magnet Recognition Program®

Structural empowerment creates a unique environment in which professional practice thrives.1 Nursing leaders at Children's Hospital Central California are committed to promoting an environment of solid professional practice to achieve the best possible outcomes Empowered nursing professional practice helps bring our mission, vision and values to life and supports outcomes of critical importance to the organization.1

Professional Practice includes engagement in professional organizations and community involvement. Members of the Children’s Hospital nursing staff are involved in many professional nursing organizations, three of which have a special connection with Children’s; the local chapters were established by members of the Children’s Hospital nursing staff. A variety of nursing specialties are represented by these chapters demonstrating the diversity of nursing expertise and interests found among the Children’s nurses.

Central California Association of Neonatal Nurses (CCANN)

CCANN was established in 2008. Kamela Loo, MSN, RNC-NIC, C-FNP, NNP-BC, Charge Nurse, Children’s Hospital, was the founder and driving force of the local chapter. Members include nurses from Children’s Hospital and other organizations throughout the region. Kamela recognized the value of bringing together the many neonatal nurses in the Central Valley to share educational opportunities, professionalism, and demonstrate the caring of nurses through their charity work. She received mentorship from the National Association of Neonatal Nurses (NANN) organization and quickly implemented those elements that help in recruitment and education. The chapter website provides comprehensive information about the chapter and its activities. The website address is

The chapter obtained a Board of Registered Nursing Continuing Education Unit (CEU) provider number and their educational activities are recognized for their quality. Physicians also attend the educational sessions. The fundraising activities of CCANN have been significant. During 2011, CCANN donated over $10,000 to charitable organizations including the March of Dimes.

In recognition of their excellence, CCANN has been awarded the 2011 NANN Chapter of the Year Award. This is quite an achievement for a chapter that was initiated in 2008. In fact, the chapter has won an award every year they have been in existence.

  • 2010 NANN Chapter Communication Award
  • 2010 NANN Education Offerings Award
  • 2009 NANN Chapter Communication Award

Their success has led to CCANN becoming a mentor for other chapters. This year several other nurses from Children’s join Kamela as officers of CCANN.

Fresno Chapter of the American Society of Perianesthesia Nurses (ASPAN)

The local chapter of the American Society of Perianethesia Nurses (ASPAN) has experienced resurgence over the last four years. Denise DeFendis, BSN, RN, CAPA, Education Coordinator, Day Surgery, provided the leadership. The organization’s focus is to provide education to the perianesthesia nurses in the Central Valley. Members from the local chapter discovered a hunger for information about the care of the pediatric patient in the perianesthesia units. Half-day seminars are offered focused on care of pediatric patients. Typically 35 to 40 attendees from all over the Central Valley participate in the seminars. Several Children’s Hospital nurses serve as officers supporting the organization’s efforts.

The leadership provided by Children’s staff extends beyond the local chapter. Denise is the Director of District #2 of the PeriAnesthesia Nurses Association of California (PANAC) and Beverly Edwardsen, BS, RN, CPN, serves as the government affairs liaison for PeriAnesthesia Nurses Association of California (PANAC).

Society of Pediatric Nurses (SPN) – Region 4, Special People Nurturing Chapter

Kathleen Remner, BSN, RN, CPN, was instrumental in establishing a local chapter of the Society of Pediatric Nursing (SPN) in Fresno. In 2009, Kathleen Remner began the process of instituting a chapter, and in 2010 enthusiastic members began meeting quarterly to provide educational opportunities and participate in charitable activities. Among their charitable activities has been the provision of toiletries to the Marjaree Mason Center, a refuge for abused women.

The chapter includes nurses from around the Central Valley and from all pediatric specialties including Home Health. Several nurses from Children’s Hospital are serving in leadership positions.

Nurses’ involvement in professional organizations has resulted in improvements to patient care and the professional practice of nursing.

Association of Pediatric Hematology/Oncology Nurses and Chemotherapy Safety

Craycroft is an acute care unit that primarily cares for pediatric hematology and oncology patients. Nurses participate in the Association of Pediatric Hematology/Oncology Nurses (APHON) and have integrated the APHON professional standards into practice. The outcomes include refinement of Oncology Core curriculum which resulted in an increase in nationally certified nurses from 14.58 percent in 2008 to 34 percent in 2011. The APHON chemotherapy and biotherapy provider course as the standard for nurses administering these agents was implemented. Children’s is the only site between San Francisco and Los Angeles offering the course.

Vermont Oxford Network (VON) – Neonatal Intensive Care Unit

Children’s Hospital nurses participate in the Vermont Oxford Network (VON), a nonprofit organization with over 900 member hospitals around the world. Its mission is to improve the quality and safety of medical care for newborn infants and their families. The Neonatal Intensive Care Unit (NICU) joined the NICQ 2009 Collaborative to focus on reducing chronic lung disease in infants with a birth weight of less than 1500 grams by implementing “Potentially Better Practice” (PCP). Children’s Hospital chronic lung disease rates significantly improved exceeding established goals through the implementation of best practices identified by the collaborative.

Commitment to Community Involvement

Providing high-quality patient care is the single greatest contribution the Hospital makes toward advancing the health and wellbeing of children. The Hospital appreciates its unique position to support the needs of children through community-based collaboration. Several key areas have included child abuse prevention, injury prevention and professional outreach education.

The Guild’s Child Abuse Prevention and Treatment (CAP-T) Center at Children's Hospital Central California, Child Advocacy Clinic

The mission of The Guild’s Child Abuse Prevention and Treatment Center (CAP-T Center) is to provide comprehensive services to children and their families through a multidisciplinary, child-friendly program designed to meet the physical and emotional needs of children suspected of being abused or neglected. The Center provides expert diagnostic/forensic evaluations, therapeutic evaluations and treatment services. The CAP-T Center works to protect children from harm by providing education, assessment and outreach to assist in supporting a safe and secure environment. Children’s Hospital participates in partnerships with a multitude of community-based partners for child advocacy including agencies in Kern, Fresno, Tulare, Madera, Mariposa and Kings Counties. Outcomes include the early identification and treatment of physical, emotional, and developmental problems of children in foster care. Training on abuse and neglect has been provided for judges, attorneys, social workers, health professionals and other community members.

Injury Prevention Community Outreach

Children’s Hospital Central California Trauma Services includes an active injury prevention and professional teaching/outreach component. A very dynamic network of cohorts, first established in 2003, has continued to grow with partnerships of well over 100 agencies and groups. The Children’s Hospital team of over 75 volunteers provided an estimated total of 12,330 children and families with education on a wide variety of child safety topics in 2011. Topics provided to the Community have included: Shaken Baby Syndrome, the Choking Game, Health and Safety Helmets and Wheeled Sports, Distracted and Reckless Teen Driving, Halloween Safety and Water Safety.

Children’s Hospital was instrumental in promoting world-wide collaboration through the development of the first international summit in the United States focused on the Choking Game. The summit was held in Arlington, VA June 18, 2012. The Dangerous Behaviors Foundation, on which Carlos Flores, ASN, RN, MICN, FCN, Trauma Coordinator, serves as a board member, was awarded a $10,000 grant from Pepsi to host the event. In attendance were three prominent experts on the topic. Sixty-five parents of children lost to this activity participated. Attendees came from as far as France, South Africa, Australia and Canada. In June 2012, Carlos met with several congressmen and congressional aides, including representatives for Congressmen Denham, Cardoza and Costa, to educate them on the topic.

In 2011 Children’s Hospital completed a second year as the lead agency for Safe Kids Central Valley (SKCV), a coalition of local agencies comprised of law enforcement, public health, education and child welfare groups. SKCV is one of more than 600 member coalitions and chapters of Safe Kids USA.

Though separate from the Hospital’s Injury Prevention program, the Kohl’s Water Safety program is closely related. Since 2000, it has been led by Mary Jo Quintero, RN, CCRN, CPN, MICN, and has educated tens of thousands of Central California children and families with a variety of a water-safety messages and curricula. The Kohl’s Water Safety program educated over 25,100 children and families through over 50 programs and projects in 2011. Mary Jo contributed to the development of the Drowning of 1-to-4-year-old Children in Swimming Pools and Spas Surveillance Handbook (2010) California Chapter 4, American Academy of Pediatric Injury and Violence Prevention Program.

Professional Outreach Education

Children’s Hospital is committed to providing pertinent education to referring providers and facilities and partnering with them to enhance services in their local area whenever possible. Outreach activities are established based on requested and/or assessed community need.

Children’s Hospital staff collaborates with the requesting organization to identify the need and how it may be met with the expertise provided at Children’s Hospital. An individualized plan is developed in accordance with findings from this educational needs assessment. The plan may include didactic and/or observational experiences.

The Pediatric and Neonatal Outreach Education teams provided customized pediatric and/or neonatal educational needs assessments and recommendations for multiple local healthcare organizations in 2010 and 2011. Programs/services provided to healthcare providers in the Children’s Hospital service area included:

  • Case Reviews
  • Pediatric Focused Lectures
  • Neonatal Intensive Care Unit (NICU)/Transport Site Visits
  • Child Maltreatment
  • Neonatal Focused Lectures and Skills Labs
  • Neonatal Stabilization w/Simulation Mock Codes
  • Monthly provider education with topics such as, Pediatric Emergencies, Stabilization of the Ill Newborn, Pneumonia and Croup, Asthma/Bronchiolitis, Respiratory Emergencies, etc.
  • STABLE Course/Cardiac Module
  • Neonatal Resuscitation Program (NRP) Instructor
  • Physical Assessment with Simulation
  • Onsite conferences – NICU Regional Conference, Pediatric Regional Conference, Diabetes Care Conference, Palliative Care Conference
  • Pediatric Clinical Symposiums
  • Trauma Nurse Core Course (TNCC)/Emergency Nurse Pediatric Course (ENPC)
  • Tracheostomy and Gastrostomy management
  • Nursing Practice Speaker and Consultation

Structural empowerment can be described as the structures; (e.g., policies, councils and processes) within an organization that empower nurses to practice in a professional and autonomous manner.  This allows nurses to achieve the highest degree of clinical excellence and professional fulfillment. Flat, decentralized structures which provide shared decision-making processes are common in a Magnet® environment. With structural empowerment, Children’s demonstrates a commitment to continual learning and educational and career advancement.


1 2012 American Nurses Credentialing Center, Magnet Recognition Program® Retrieved from



In This Issue

Magnetically Charged

Leadership That Transforms

Empowered Nursing

Exemplary Care

Innovations In Nursing

The Magnet Culture

Meditech Scanning and Archiving