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Title: The Nurse Executives as a Transformational Leader Inspiring Excellent in Pressure Injury Prevention

Natalia Cineas

Mount Sinai St. Lukes West, USA

Biography

Dr. Cineas began her nursing career as a staff nurse in the Neurosurgical Intensive Care Unit, then worked as a Quality Management Specialist for the Cardiothoracic Department and became Patient Care Director of Neurosurgery and the Neurosurgical Intensive Care Unit at Columbia University Medical Center New York Presbyterian Hospital in New York, NY. Dr. Cineas served as Senior Director of Nursing and is currently Deputy Chief Nursing Officer at Mount Sinai St. Luke's. 
She has a Doctorate of Nursing Practice degree from The George Washington University, a Masters of Science in Management and a Bachelors of Science from New York University, and a Bachelors of Arts degree in Psychology from Stony Brook University. 
Dr. Cineas is adjunct faculty at Columbia University School of Nursing where she teaches nursing leadership courses in the doctoral and masters level degree programs. She is also adjunct faculty at The College of New Rochelle where she teaches Healthcare Politics, Nursing Research and Leadership.
She is Vice Chair (Internal affairs) of the Health Ministry at St. Charles Borromeo Catholic Church in Harlem, NY. As Vice Chair of Internal Affairs Dr. Cineas ensures preventative screenings take place with the goal of improving health disparities among Harlem residents. 
Dr. Cineas is a board member of the New York Organization of Nurse Executives, member of the American Nurses Association, American Organization of Nurse Executives, National Black Nurses Association, American Association of Critical Care Nurses, Sigma Theta Tau International and Delta Sigma Theta Sorority, Incorporated.
In 2010, Dr. Cineas was inducted as a fellow of the Leadership Institute of Black Nurses at New York University (LIBN).
In 2015, Dr. Cineas was the recipient of the Top 40 under forty award from Stony Brook University. 
In 2016, Dr. Cineas won first place for the Claire Murray Best Practice Award demonstrating her passion in improving patient satisfaction and leading organizations to reduce hospital-acquired infections through evidence-based practice. 
In 2017, Dr. Cineas was a Nurse.com Gem Award Finalist for Excellence in Executive Leadership Northeast Region. Dr. Cineas also became a fellow of the New York Academy of Medicine and board member of the Center of Healthcare Innovation. 
Dr. Cineas continues to impact health care locally, nationally and internationally. Her international work includes studying the pathophysiology of AIDS in Uganda, Africa. In May of 2018, she presented her work on Diversity and Inclusion at the National Medicine Association Conference in Jamaica. In September of 2018, Dr. Cineas presented her work on reducing Catheter Associated Urinary Tract Infections in Dubai, UAE and Rome, Italy. 
 

Abstract

Hospital-acquired pressure injuries (HAPIs) are a largely preventable complication that negatively affects an organization’s reputation and finances. Practice, knowledge, and education chasms were contributing to waste and an unfavorable trend in HAPIs at Mount Sinai St. Luke's emphasizing the need for robust process improvement. 
The Deputy Chief Nursing Officer emerged as a transformational leader by engaging key stakeholders to evaluate current evidence. Using the Plan-Do-Study-Act (PDSA) quality improvement methodology, nurses in the targeted community led and coordinated a multi-faceted pressure injury prevention program. A needs assessment was completed to identify the root causes of the higher than acceptable pressure injury incidence. An interprofessional team, comprised of twenty-one key stakeholders, was convened for a collaborative approach to addressing identified gaps. The team employed lean methodology, current evidence, and innovative solutions to structure and streamline care delivery, health professional education, and products to reduce pressure injuries hospital-wide. The electronic health record was modified to reflect expected practice and improve documentation accuracy. Routine rounding was executed to assess, reinforce, and measure compliance.  Pre- and post-intervention pressure injury incidence and cost outcomes were measured. In 2018, HAPIs decreased from a total of 19 HAPIs in February to 7 HAPIs in September, representing a 63.2% reduction. An estimated $483,000 was saved in treatment costs, and an estimated 84 hospital days avoided and reportable pressure injuries were reduced from 5 to zero. This presentation will provide highlights of transformational leadership, process standardization, product implementation and outcomes of the Inter-professional Collaboration.