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Executive Nurse Director's Report at the July 21, 2010 Annual Meeting...

 

MOUNT DESERT NURSING ASSOCIATION

 

Executive Nurse Director’s Annual Report--2010

TO:                  Board of Directors

FROM:            Anne Napier, Ed. D., RN, APRN-BC, Executive Nurse Director

RE:                   Fiscal Year July 1, 2009 to June 30, 2010

 

Patient visit statistics for July 1, 2009 to June 30, 2010

July 2009                     138 visits                      January 2010                  92 visits

August 2009                 108 visits                      February 2010               97 visits

September 2009           119 visits                      March 2010                 118 visits

October 2009              124 visits                      April 2010                    114 visits

November 2009             95 visits                      May 2010                    106 visits

December 2009           106 visits                      June 2010                    118 visits

Total –1335 visits

 

The Mt. Desert Nursing Association is a private, non profit community health agency that receives no third party reimbursement. We offer home health care to those without insurance or with needs that are not covered by insurance.  Sources of support come from fund drives, a town stipend, an endowment and a modest sliding fee scale. Patients determine what they feel they can afford and no one is denied services based on their ability to pay. We also offer office-based nursing care, maintain a free “loan closet” of durable medical equipment and we sponsor free community health education and health screenings. 

The Nursing Association is governed by a volunteer Board of Directors, includes a Board of Corporators, is staffed by three registered nurses and an administrative assistant and is licensed by the State of Maine.

 

In the past year, MDNA has had 19 admissions, and 20 discharges including 6 deaths.  MDNA nurses have called the ambulance 6 times on behalf of patients.  Sixty one patient visits were made to the office.  The Loan Closet provided durable medical equipment to 211 MDI residents, for a total of approximately 600 pieces of loaned equipment.  Most of this equipment is returned within a few weeks or months, and then needs to be cleaned and restocked into the basement. So Patti took care of approximately 1100 pieces of durable medical equipment in the past year

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In addition to regular patient care visits, the nursing staff spends many hours conferencing with health care professionals, individuals, and families by phone.  In the past year our RNs, have made approximately 2,274 follow-up phone calls to families, physicians, clinics, labs, and other health care providers, to manage the care of our patients, to make referrals, all of which are to facilitate our patients’ well-being.  These calls and consultations represent the care manager aspect of our nurses’ service to patients, and that number does not include any of the many calls Patti or I make to and about patients.  MDNA patients are becoming more frail, with more choric health problems, which require increased skills, knowledge and an increase in the amount of time needed for each nurse visit.

 

Beside our usual home care visits we gave 10 H1N1 flu vaccines to home bound patients, and residents at the Maple Lane Apartments. Our Registered Nurses have continued to visit our patients at local hospitals and our former patients at nursing homes.

 

            As part of our quality improvement program MDNA has continued quarterly patient record reviews of active and inactive charts, and has maintained 100% compliance throughout the year. In February, the State Licensing Bureau made a site visit to MDNA.  The site inspector, who was an RN, was very impressed with the patient charts, especially the documentation by the RNS, and with the END reports.  She found one omission which was easily remedied, and our license was renewed again by the State of Maine.

 

            MDNA is represented on the Healthy Acadia “Healthy Ageing” and “Access to Care” Task Forces, serves on the Advisory Councils of Healthy Acadia, and Healthy Acadia Asthma Project, as well as attending meetings of Island Connections, Mt. Desert TRIAD, Pan Flu Working Group, MDI Non-profit Association, and Southwest Harbor/Tremont Nursing Services.

 

            Our Community Outreach this past year has included a Men’s Clinic, on-going Cane Clinics and assessment of durable medical equipment for safety and correct functioning of devices, Abby Chapel Luncheon Blood Pressure checks, weekly TOPS (Take Pound Off Sensibly) support meetings, and our island-wide loaning of durable medical equipment from our Loan Closet.  In addition, we provide a variety of services at the office for those who come into the office needing them.  Two of MDNA’s Per Diem RNs are Community Health Outreach Workers (CHOWs) in the new Healthy Acadia Asthma Project.

 

            A new Community Outreach Program this summer is the MDNA-sponsored Summer Synergy Lecture Series, a series of four lectures in July and August which focus on non-traditional approaches to healing which are complimentary to traditional medicine.  Speakers include William (Mac) Bigelow speaking on Aesculapius and Healing, Dan Torinus presenting on Acupuncture and Healing, Jen Munyer speaking on the healing aspects of Yoga, and Sudama Mark Kennedy presenting on Spirituality and Healing.  The first lecture had 53 attendees.

 

            Another “first” for MDNA this year is the acquisition of 3 Panasonic C1 Toughbook laptop/tablet style computers, purchased with a generous donation from Stocky Smith. This will allow our RNs to ultimately move from hand-written patient records to electronic patient records, and facilitate their communication with other health care providers and family members.  A recent grant from Bar Harbor Bank and Trust and a grant from the Lynam Family Trust have provided funds for both the software for the new computers, and GiftWorks Premium, a donor data base very well suited to MDNA needs for the MDNA Endowment Campaign which began this spring.

 

            One additional achievement in the past twelve months was a full-page article in April in the Bar Harbor Times, complete with photographs and beginning on the front page, which featured the Mount Desert Nursing Association and the services it provides to the residents of Mount Desert.

           

This year the Mount Desert Nursing Association celebrates its 61st year of providing nursing services and community health programs to the residents of the Town Mount Desert.  There have been many changes during those years, but the underlying concept remains--of providing care to patients in their homes, allowing them to continue as long as possible with the best achievable health and lifestyle, and supporting healthy life styles through community health education. 

 

The current population of the Town of Mount Desert is made up of approximately 2000 year-round residents, and somewhere between 6000-8000 seasonal residents.  The average number of patients seen weekly by our RNs is 38-43.  The average length of a visit is 90 minutes, with some visits lasting as much as 3 hours.  The average number of weekly phone calls made by RNs to coordinate patient care and to facilitate the well-being of our patients is 197.  Our Administrative Assistant made approximately 1,567 calls on behalf of our patients last year. Our Loan Closet provided over 600 pieces of durable medical equipment to 211 persons. 

In the 61-year history of the Mount Desert Nursing Association, Registered Nurses have provided 86,793 visits to patients who were, or are, residents of the Town of Mount Desert.

I have been monitoring the new Health Care Reform Act in the areas of Home Health Care, Community Health and Nursing.  There is a major shift in payment focus from acute care to an emphasis on prevention and wellness through both Community Health programs and Home Health, with the goal of having healthier people who can remain in their homes longer.  This is a cost-savings to both individuals and tax payers in general.

 

The new HCR Act also acknowledges the value of nurses and nursing services, and increases promotion of nursing services in prevention and health maintenance, with support for nurse-run community clinics and school-based clinics.  Some of the financial support in the HCR Act is not accessible to MDNA because we do not bill insurance or Medicare/Medicaid.  However, as the Act evolves, it might mean MDNA can access some Federal funding.  At least, the bill is very supportive of all the things MDNA has believed important and has been providing for many years.  What MDNA does well is to focus on all aspects of patients’ lives:  keeping them well, providing care when they are ill, and getting them back to normal activities as soon as, and as much as, possible.  So MDNA is already doing much of what is in the new HCR Act.

In the 116 years since the birth of the visiting nurse model the number of home care community nursing agencies has increased from seven to more than 45,000 today, an increase of 10,000 in the past year, and this number continues to rapidly grow as more people seek home care services, and prevention moves to the forefront as more cost-effective medical care. I would venture to say very few community and home health nursing agencies can claim to be independent, patient and community-centered rather than business-driven organizations.  I have tried to research this approach to patient care, and believe the Mount Desert Nursing Association may be unique in the US.   This concept is key to the philosophy of the Mt. Desert Nursing Association –caring for patients in their homes, with dignity and helping them achieve the best possible quality of life-- that it’s not about the income and profit, but is about the patient’s needs, their family’s needs, and the community’s needs which are the absolute priority.

 

The need for Home Care is growing exponentially, with Baby Boomers retiring and wanting the kinds of services that will enable them to remain living independently, and with dignity in their own homes.  Thank you for giving MDNA staff the task of caring for the residents of the Town of Mount Desert.  It is our privilege to care for our most vulnerable citizens, to welcome new moms with new babies, and to facilitate the healing of those recovering from illness, trauma or surgery.

 

            I would like to thank the MDNA RNs—staff nurses Emma Lansing and Theo Hinckley, and Per Diem nurses Karol Hagberg, Kathy Frank, Sarah Somes, Susan Roche, and Joyce Anderson for their very hard work and commitment to our patients; to Patti Billings for managing our office so efficiently, and for her great skill in data and financial management of the office, for keeping the Loan Closet equipment clean and organized, and for keeping nursing and patient care information up-to-date, and for keeping nursing supplies and equipment stocked (among her many talents); to Chiori Beck for sharing her creative skills in designing the graphics for MDNA’s 60th Anniversary Celebration, the Spring Newsletter, the flyers for the Summer Synergy Lecture Series, and the Endowment Campaign Case Statement.  Additional big “Thank You’s” go to Stocky Smith for donating the funds for computers and software for our RNs; to Bob Falt for sending his crew to put up and take down our winter entrance; to Ralph Erickson for opening up our kitchen cupboards for additional storage; to Paula Lamoureaux for helping Patti in the office; to Charles Butt for the pretty flowers in our window boxes;  to Ruth Fraley and Robert Harrington for giving MDNA a facelift with removal of the lilacs and creation of new gardens at the front of the building; and to Sydney Roberts Rockefeller for her design of the 60th Anniversary logo and for setting up the MDNA historical display in the NE Harbor Library. Finally, special thanks to all the Board members who have contributed their time, energy, knowledge, financial contributions, and on-going efforts to make sure MDNA can continue to provide excellent nursing care and community health information to Mount Desert residents. 

 

            It has been an honor, a challenge and a delight to have been the Executive Nurse Director of the Mount Desert Nursing Association this past year.  My sincere thanks to the Board of Directors and to the Town of Mount Desert for this opportunity. 

 

Respectfully submitted,

Anne

Anne Napier, Ed.D, RN, APRN-BC, Executive Nurse Director