Office of Nursing Services (ONS)

Each year the Secretary's Award for Excellence in Nursing and Advancement of Nursing Programs is given to individuals who have been nominated by their colleagues for outstanding service to our veterans and the Department of Veterans Affairs. They have demonstrated excellence and the highest level of dedication to their profession. Chosen from individual medical centers, the nominees go through a rigorous review before the final selection is made.

Chief Nursing Officer Beth Taylor and Executive in Charge Richard A. Stone, MD at virtual award ceremony

Registered Nurse: Teresa C West, BSN, RN; Little Rock, AR

Ms. West’s many accomplishments are the result of her leadership, communication, training and practice skills, paired with creativity, empathy and commitment. She uses Whole Health to impact patients in all her endeavors. Some of her accomplishments include: implementing the Virtual Medical Room program at Central Arkansas HCS and VISN 16; using Advancing Telehealth Through Local Access Stations (ATLAS) program to implement the use of Virtual Medical Rooms at public libraries within the state of Arkansas; and RN Care coordinator of the V Impact program for VISN 16, providing Patient Aligned Care Team (PACT) training at 5 other VISN 16 facilities. She works with patient educators across the VISN and at the national level to share information and ideas about patient education programs and campaigns used locally and implements new patient education topics and programs from other facilities.

Prior to becoming a nurse, Ms. West worked in sales and marketing, which has helped her with promoting new and innovative ideas throughout CAVHS and the VISN. She uses professional standards of care and practice to evaluate programs and or service activities. She has set high standards for nursing practice not just in her local Primary Care area, but throughout the VISN. She assesses the educational needs of staff and develops plans to meet the needs. She voluntarily attended 2 weeks of training on the VA Whole health Initiative. She used the information gained from the seminar, colleagues and her patients to develop and evidence-based educational program for Primary Care nursing staff to improve outpatient high risk measures such as diabetes and hyperlipidemia, thus improving SAIL scores. Ms. West has had a large impact on CAVHS and beyond the facility.

Associate Director for Patient Care Services Salena Wright-Brown presents award to Teresa West

Registered Nurse Expanded Role: Kelly Drumright, MSN, RN, CNL, CCRN-CMC, CSC; Nashville, TN

As an established Clinical Nurse Leader (CNL), Ms. Drumright’s focus centers on quality improvement, interprofessional communication, evidence-based practice, and care coordination at the point-of-care. As a CNL, she designs, implements, and evaluates patient care in her microsystem (the Medical Intensive Care Unit [MICU]). She works with the interprofessional team to ensure that care is laterally integrated and coordinated, especially in transitions to other settings. She acts as a risk anticipator, evaluating anticipated risks to patient safety with the aim to avoid medical errors and improve quality. As part of her endeavors to improve quality, Ms. Drumright pursues opportunities to provide point-of-care education that is timely and in the moment to patients, family and other healthcare providers to ensure care decisions and practice is appropriate and evidence-based. She assists staff in making appropriate assignments based on patient acuity and staff experience by applying the American Association of Critical Care Nurses (AACN) Synergy Model. Ms. Drumright’s evaluations at the point of care afford her the opportunity to monitor nursing staff and implement measures to ensure interrater- reliability. These interventions create a cohesive approach to a standardized delivery of care that further ensures the best clinical outcomes. She participates in the identification and collection of selected care outcomes and is accountable for the evaluation and improvement of outcomes.

Ms. Drumright has established herself as an expert in her field and has been recognized for her efforts by various organizations. Sacred Heart University awarded Ms. Drumright the Outstanding Capstone Award for the Clinical Nurse Leader track in the College of Nursing for the introduction and successful implementation of ICU Diaries in 2017-2018. Ms. Drumright continued her work with the ICU Diaries and was subsequently awarded the Evidence-based Practice Research Award by Clinical Nurse Leader Association in 2018. Additionally, Ms. Drumright was invited by the National Office of Patient Centered Care to develop an ICU Diary Toolkit to share with other VAs to assist them in implementing diaries in their facilities. For the impact the ICU Diaries demonstrated on mitigating the impact of Post-Intensive Care Syndrome (PICS) and for work that supported reducing the impact of delirium, Ms. Drumright received the Society of Critical Care Medicine’s (SCCM) ICU Hero Award and was invited to participate as an active member of the Thrive Taskforce, which provides the SCCM with pivotal information about the needs and families that experience post-intensive care syndrome (PICS), and continues to develop a distribution plan to share the learnings garnered for utilization by clinicians worldwide.

Associate Director for Patient Care Services Cynthia L. Johnson presents award to Kelly Drumright

Jim Luetkenhaus, LPN ; Asheville, NC

Mr. Luetkenhaus excels in his role as the Urology Nurse at the Charles George VA Medical Center. He is proactive, flexible, and committed to outstanding care of the urology Veterans. He has transformed the treatment and procedure urology clinic to a higher level of service and accessibility, raising the skill level required for the clinic such that when he is unavailable, an RN must replace him to provide the level of care required for our urology patients.

He sets up and assists in following procedures: Prostate biopsies, vasectomies, excisions, I&D, cystoscopies, stent removals, fiducial implants, and stricture and bladder neck dilations. In addition, he averages 50-65 catheter changes monthly and sees 100 patients in treatment/procedure clinic per month, 40-50 bacillus calmette-guerin (BCG) treatments per month and averages around 40 prostate biopsies a month. He gives care to the Community Living Center residents and inpatients who need catheter changes and/or assists with difficult catheter insertions as the urology resource for outpatient and inpatients. He has assisted in developing standards of care for BCG with Interferon instillation and collaborating with Oncology RNs for chemotherapy instillation. He frequently assists the junior and senior Duke Urology residents and was nominated by them for an award. Mr. Luetkenhaus will receive the Urology Nurse of the year award in Durham, N.C.

He has implemented an atmosphere of commitment and centralized care by allowing same day clinical appointments for walk-ins, seeing numerous same day appointments from Veterans in need of urgent care. He has a significant role in developing plans of care for the Veterans. The data listed below is how many Veterans Mr. Luetkenhaus has seen in the past year. He has documented on 3975 Veterans 2018 until June 10, 2019. He has had 1276 encounters, 1257 visits and treated 672 unique patients.

Mr. Luetkenhaus works daily in conjunction with the Urology Case Manager and the multidisciplinary team in the Urology Clinic. He is also the Flu Champion and provides immunizations to the Veterans and the staff. Mr. Luetkenhaus is certified in Urology and continues to impress as a change agent, attentive and dedicated to the Veterans in the Urology Clinic and as an advocate for the Veterans.

Director Stephanie Young presents award to Jim Luetkenhaus

Nursing Assistant: Saretha Cannon, NA; Hampton, VA

Ms. Cannon is assigned to the Community Living Center (CLC) Hampton Roads Estates (HRE) neighborhood consisting of residents with Dementia and/or Disruptive Behavioral concerns. She consistently exhibits leadership qualities and promotes cohesiveness among her coworkers by the energy and enthusiasm she exhibits She has the knowledge and skills necessary for concentrated effort and self-direction in carrying out the most complex nursing care assignments to this population. Her approach has helped the unit staff grow as a team towards meeting this standard of care across all tours of duty.

In one key example of improving patient care to Veterans, Ms. Cannon identified a creative intervention for a resident that was experiencing extreme disruptive behaviors. This resident, who had severely declined in health, was agitated, yelling, showing a lack of interest in activities, and not sleeping at night. After multiple unsuccessful attempts with medication management and activity adjustments, she provided the idea of using a weighted vest on the resident, a non-pharmacological technique that provides deep pressure touch therapy to the upper body to reduce anxiety and stress, providing a calming effect. Ms. Cannon demonstrated leadership by combining her experience with evidence-based practice research on weighted vests and blankets. Her actions resulted in the development of a proposal in collaboration with the Occupational Therapist (OT) on how to use the weighted vest on HRE residents. The proposal included: background information on residents' behaviors, cases for using weighted vests, how to use vests, benefits, proposed changes and indicators of success. Ms. Cannon never lost focus on her primary goal, which was to recognize and respect the rights and dignity of the residents. The proposal was accepted and implemented in CLC and has resulted in significant improvement in the behavior of this resident as well as others demonstrating disruptive behaviors utilizing a non-pharmacological approach.

Ms. Cannon has presented this good news weighted vest story alone and in collaboration with OT in the Director's morning report with Quad members and Services Chiefs, the facility evidenced- based committee and the VISN 6 Newsletter. There is also a Video on the HVAMC Facebook (internal and external customers) explaining how Ms. Cannon came up with the idea, its use, demonstrating how to put the weighted vest on, preferences and safety features. The Associate Director for Patient Care Services (Associate Director for Patient Care Services) also shared the CLC weighted vest good news story at the VISN 6 Network Directors meeting and received rave reviews. These presentations have increased the awareness and benefits of its use both internally and externally. The use of the vests has expanded to other areas in the facility (i.e. Spinal Cord Injury, Acute Care) and an SOP and competencies have been developed for weighted vest and blanket.

Ms. Cannon continually identifies learning needs for herself and maintains knowledge on the care of the CLC residents with Dementia, physical, emotional or behavioral changes through attending in-services, and reviewing evidence-based literature. She assists with orienting newly assigned staff. Ms. Cannon serves as preceptor to newly hired nursing assistants, demonstrating excellent teaching skills, and receives compliments her for her wealth of knowledge of the unit and the residents (diagnosis, behaviors and how to work with them during certain situations). She displays a calm easy-going demeanor that makes her easily approachable and well-liked by the residents, interdisciplinary team members and co-workers.

Associate Director for Patient Care Services Crystal Lindaman presents award to Saretha Cannon

Nurse Executive:David Przestrzelski, MS, RN; Ashville, NC

Mr. Przestrzelski has served Veterans for 40 years in various nursing leadership roles within the Department of Veterans Affairs. He is extremely dedicated and valued as a leader at his facility and across VHA. Mr. Przestrzelski is a model of progressive leadership with a focus on the advancement of nursing practice. He encourages Nursing Service in innovation and out-of-the-box thinking. His leadership style supports engaged growth in professional practice based on standards of care, measured by outcomes and a focus on achievement.

As a strategic leader, Mr. Przestrzelski is committed to nursing workplace excellence, developing a Shared Governance structure and Professional Practice Model that has been presented nationally. Annually, he shares All Employee Survey (AES) results with all of nursing and challenges the facility staff-led Shared Governance Councils to utilize the data to develop Nursing Service goals. All goals are clearly defined and measurable. As a result, Nursing Service has led improvements in Care Coordination; bedside reporting that includes Veterans and caregivers, which has increased satisfaction scores for communication with nurses; the availability of integrative therapies to promote Whole Health; and nursing documentation that incorporates Veteran’s personal health goal setting. Mr. Przestrzelski maintains a relentless focus on care of Veterans and staff needs. His leadership style has created a culture that has resulted in a steady applicant pool of qualified candidates desiring to join the nursing team based on the reputation of the work and practice environment. The facility ranked fifth Best Place to Work among VA facilities.

Assisting others to grow and develop is a strength of Mr. Przestrzelski, who mentors and coaches current and new staff, developing and encouraging staff participation on national committees. Currently, several nursing staff are participating on national committees as well as on regional workgroups to improve and evaluate practice initiatives and disseminate locally. Facility nurse-driven protocols have been developed, for example: isolation order set allowing staff to initiate isolation precaution; implementation of Nurse CHF screening; and a Foley Out Protocol, which allows RNs to drive the removal of catheters, which in turn decreases the incidence of catheter-associated urinary tract infections (CAUTIs). The Foley Out protocol resulted in a decreased incidence of twelve (12) CAUTIs in 2013 to zero (0) in 2018.

Mr. Przestrzelski’s leadership has had a national impact in the professional community. He contributed to the implementation of a nationally standardized staffing methodology initiative through a review of best practices and innovative approaches to measure the impact of staff levels and skill mix on patient care outcomes for consistent staffing standards. He represents VISN 6 on VACO Office of Nursing Service Executive Leadership Board. He serves as the Chair of the VISN 6 Pain Committee as well as on the National Pain Committee, effectively leading teams and initiatives to reduce opioid usage across the VISN and within the facility. He is the sole clinician on the Logistics Subcommittee of the Resource Committee of the National Leadership Board and clinician-driven sourcing has evolved with his guidance. Mr. Przestrzelski also serves as an engaged member of Advisory Councils for three nursing programs. Through collaboration and involvement, he works with the academic leadership teams to develop ideas and plans to advance the mission and vision of the nursing programs. He provides guidance regarding the curriculum to develop the nursing workforce needed for the future. He successfully collaborated with a BSN program to obtain grant funds to expand the Accelerated BSN program to increase the number of BSN prepared nurses to meet the demand for care. He is a community leader in the support of students in Transition to Practice programs and utilizes the VALOR program to align future nurses within the VA.

Mr. Przestrzelski is an advocate for sharing best practices with other facilities. In the last year, Ashville VAMC was designated as a Pathway to Excellence® facility. He serves as the Nurse Executive Advisor for the VHA ONS Nursing Excellence Collaborative and on its Steering Committee, providing support and guidance to other facilities seeking this designation. He was recognized as one of the Great 100 Nurses of North Carolina for nursing excellence. Mr. Przestrzelski is a transformation leader experienced in engaging and inspiring employees and fostering a professional practice environment of continuous learning, responsible risk-taking, and personal accountability to optimize patient centered care and clinical outcomes.

Director Stephanie Young presents award to David Przestrzelski

Director: Joe D. Battle; Tampa, FL

Mr. Battle has created a culture of continuous improvement and scholarly inquiry that has led to numerous measurable outcomes over the past 4 years. During Mr. Battle’s tenure, JAHVH progressed from the 71st ranked facility in SAIL to 13th ranked among all 152 VHA facilities, making JAHVH a 5-star facility. This dramatic organizational improvement would not have been possible without his acknowledgment of nurses as partners and leaders in improving the quality and accessibility of care for Veterans. Mr. Battle ensures that staff nurses are empowered with knowledge and have parity with other healthcare professionals in the organization.

Recognizing the pivotal role that nurses play in keeping patients safe and improving quality outcomes, Mr. Battle supported the creation of a Chief Nurse for Quality Improvement. With a sensitivity to operations at the front line, Mr. Battle recognizes that nurses are perfectly positioned on the journey to become a High Reliability Organization (HRO), by recognizing and reporting small problems before they cause harm to patients. He demonstrated support of evidence-based nursing by endorsing the creation of a Chief Nurse position when the Associate Director for Patient Care Services (Associate Director for Patient Care Services) conveyed the need for a nursing leader to facilitate the translation of research into practice. This allowed the development of an Evidence-Based Practice Committee under our Nursing Shared Governance structure.

Mr. Battle advocates for advanced practice nurses (APRN) to practice autonomously in accordance with their professional training and education and APRNs are embedded in all care settings. He is a strong proponent of a highly productive, inter-professional health services research program with nine federally funded investigators and over 40 staff, including nurse scientists, statisticians, methodologists, and project management and administrative staff. This program of research focuses on improving outcomes for Veterans with disabilities and their families, including community reintegration, adverse events, pain, suicide risk, Veteran engagement, and quality of life. The nurse-directed Nursing Innovations Center for Evaluation, funded by VA QUERI and the Office of Nursing Services, conducts evaluations of priority programs to inform policy.

Since Mr. Battle’s selection as Director, the VA National Education for Employees Program (VANEEP) was reinitiated to create opportunities for employees to become RNs. In three cycles, 31 employees without RN licensure entered the program. To promote professional development of RNs, Mr. Battle fully supported 45 RNs for a total of $629,646 in National Nursing Education Initiative (NNEI) scholarship funding for Bachelor, Master, and Doctoral level education. Funding for the Tuition Assistance Program (TAP) steadily increased to $95,000 in FY19.

Supporting the evidence-based nurse staffing methodology process, Mr. Battle recognized the need to include performance improvement activities for staff nurses into JAHVH staffing models. Our nurse staffing levels are above the mean of comparable facilities that subscribe to the National Database for Nursing Quality Indicators (NDNQI). This has contributed to a low RN turnover and an environment that maximizes nursing workforce capability. Our high retention of nurses is evidence of a workplace culture that recognizes nursing as a unique clinical practice discipline, uses staffing methodology tools to sustain adequate staffing levels, and has a well-established Shared Governance program to provide nurses a voice in decision making around workflow and policy development. Nurses are members and co-chairs of over twenty-five organizational committees.

Associate Director for Patient Care Services Laureen Doloresco presents award to Joe D. Battle