Patricia Geddie, PhD, CNS, AOCNS®

Patricia Geddie, PhD, CNS, AOCNS®

Winter Park, FL

Audio Recording

Position: Director-at-Large

Patricia I. Geddie, PhD, CNS, AOCNS®
Clinical Nurse Specialist
Orlando Health
Winter Park, FL

ONS member: 28 years

2015, PhD Nursing, University of Central Florida
1991, MS Nursing, CNS program, University of Oklahoma
1982, BSN Nursing, Florida State University
1978, Diploma, Amos P. Godby High School

ONS PARTICIPATION (national and local):
Current: Member, Oncology Nursing Society, CNS SIG, Research SIG
2017: President, Central Florida ONS Chapter
2011: Pilot Reviewer and content expert, ONS Caring for the Older Adult with Cancer Trainer Course
2008 - 2009: Development team and content expert, ONS Treatment Basics Course development and presentation at ONS Pre-Congress Session
2008: Field Reviewer and content expert, "So You Want to be an Oncology Clinical Nurse Specialist?" book 2005: President, Central Florida ONS Chapter
2004 - 2005: ONS Congress planning committee member, plan and coordinate sessions and volunteers for ONS Congress at Anaheim, CA and Orlando, FL
2005 - present: ONCC Certification Advocate
2002: OCN Item writer and content expert

2013 - 2017: Oncology Clinical Nurse Specialist, Corporate CLABSI SAFE Team, Coach for Medical Oncology and Surgical Oncology Quality PI teams
2010 - 2013 Oncology CNS, develop and grow in-patient and out-patient oncology nursing servies and competencies at smaller community hospital within large multi-hospital system, prepare team for external oncology surveyor.
2007 - 2010, Chair, Clinical Nurse Specialist SIG
2007 - 2009, Chair, Corporate Oncology Nurse Practice Council
2007 - Clinical Nurse Specialist, Corporate Blood Culture Contamination PI
2000 - present - Oncology Clinical Nurse Specialist for adult oncology service line for nursing practice policy and procedure content development, nurse skills check lists, oncology nurse courses, standardize oncology nursing practice and procedures across OH hospital system.
1995 - 2000 - Oncology Clinical Nurse Specialist for adult oncology service line for nursing practice policy and procedure content development, nurse skills check lists, oncology nurse courses, standardize oncology nursing practice and procedures across FH hospital system.

2016 - 2018 Secretary, Sigma Theta Tau, Theta Epsilon, Orlando, FL
2014 - present Co-chair Florida Nurse Association (FNA) CNS SIG
2013 - present Member, National Association of CNS and Florida CNS Affiliate
2011 - present Member, Southern Nursing Research Society
2006 CNS representative, Florida Nurse Association Lobby Days, Tallahassee, FL

Position Statement: As a Clinical Nurse Specialist, my passion is to advance the practice of oncology nursing. I engage daily with oncology nurses and am acutely aware of current practice issues and challenges. The knowledge and skills I gained from graduate work has also equipped me to search, analyze, translate, and generate evidence for appropriate dissemination and implementation. In addition, I remain current regarding oncology nursing issues and trends through literature, professional meetings, and networking with other healthcare professionals. I have system leadership experience leading oncology and general quality and safety initiatives across a large multi-system hospital such as chemotherapy safety, sepsis, and central line infection prevention. I am skilled in adapting communication styles to meet diverse individual and group needs. I embody strong organizational and collaborative skills to build relationships that influence others and achieve goals. For example, I coordinated all Florida ONS chapters to serve as host and volunteers during the 2005 Congress in Orlando, FL. I have served and continued to serve as a leader in oncology nursing and clinical nurse specialist group. These characteristics and qualities have prepared me to successfully lead nursing and multidisciplinary groups at the work place, local chapter, and state level.

How have you advanced excellence in oncology nursing and quality cancer care? I am driven to advance excellence in oncology nursing and quality cancer care through quality improvement initiatives and research. One of my CNS role responsibilities is to serve as a coach to oncology unit nurse practice councils for performance improvement initiatives. The literature has reported unplanned hospital admissions are recurring and costly. Also, patients with advanced disease are often referred late to hospice. Last year, I led the medical oncology and surgical oncology unit nurse practice councils to conduct a retrospective analysis identifying key predictors of mortality, length of stay, and discharge disposition for patients with stage 4 solid tumor diagnosis. This year, we are identifying patients prospectively and prompting physicians for earlier hospice conversations.

For 3 years, I have served as a co-investigator of a nursing research study to explore older adults experiences with self-management of chemotherapy symptoms. I was thrilled to present an e-poster at the 2017 ONS Congress about using community advisory boards to develop a new and unique intervention to assist older adults with symptom self-management. This year, we are testing the intervention for feasibility and utility during chemotherapy treatments.

Provide a recent example of how you used innovation in your leadership experiences. Oncology patients have the majority of chronic central line devices than any other population at my facility. Cancer treatment induced immunosuppression increases the risk for central line blood stream infections which can result in sepsis and death. Central line maintenance care and CLABSI prevention is a primary nursing responsibility. I lead the hospital system's central line blood stream infections (CLABSI) team. In an effort to identify root causes and influencing factors that may contribute to CLABSI, each unit conducts a weekly CLABSI audit of observable maintenance care. The paper audits were not always completed and submitted in a timely manner, not always scan clearly, and the data had to be transposed into an excel file which is error prone. I collaborated with an informatics nurse to create an electronic CLABSI audit. The e-audit had all of the items from the paper form which was easy for end users conversion. Since the implementation of the e-audit, data is entered in real time and can be analyzed for trends and gaps. The next step is to create an e-form for unit CLABSI intensive reviews.

Provide a recent example of how you used advocacy in your leadership experiences. Standardized electronic nursing documentation formats do not always meet oncology nursing documentation needs. Patients are at risk for chemotherapy toxicity if pre-assessment documentation is not clear and standardized. This was especially evident for pre-Cytarabine neurologic documentation. The existing neuro assessment fields were too general and specifics had to be hand typed in empty fields which resulted in variation. I gathered examples of varied nursing neurologic documentation, a couple of cases of "near miss", and aligned the request to the organization's focus on safety. I submitted an urgent need to clinical informatics and cancer administrator advocating for an urgent need to add a specific and standardized neuro parameter for pre-chemotherapy assessment in the electronic medical record. The request was advanced to the top of the que. Today, there is a "Drug Toxicity Neuro Assessment" parameter available and is used by oncology nurses to document a standardized oncology specific neurologic assessment prior to each Cytarabine dose.