DAISY Award—Sheryl Ruth, MS, RN, NEA-BC
Sheryl Ruth, MS, RN, NEA-BC
Nurse Leader, Davis 5
We would like to nominate Sheryl Ruth the Nurse Manager for the NICU. Sheryl epitomizes all the qualities of a great leader and manager. She has a keen understanding of the university system and key players.
Sheryl Ruth did not set out to be a great leader, she simply wanted to make a difference. Nearly a decade ago, she came to our NICU during a difficult time. Our census and our morale were incredibly low. She got to know our unit, patient population and staff, and breathed new life into our unit by finding creative ways to increase our census and our outlook.
Sheryl focused on building relationships with community hospitals through NICU outreach programs. This outreach includes additional education and training for many community hospitals, such as Adventist Health Lodi Memorial Hospital, Adventist Health Rideout Hospital, Barton Memorial Hospital, and Oroville Hospital, improving care at their facilities and allowing more patients to stay at their home hospital. It too improved communication between our facilities so that when a baby needs to be transferred, the specialty care we provide here at UC Davis is readily available remotely while our NICU transport team is deployed. She continues to recognize the importance of building relationships, from staff, consulting services, and referring hospitals. She helped create the NICU outreach coordinator position and diligently works with our partner hospitals to improve patient outcomes throughout the community.
Strong leadership through difficult times is essential and requires a delicate balance of maintaining both short- and long-term goals, all while empowering and supporting staff. Sheryl empowers staff to problem-solve and implement solutions. For example, when an increase in Central Line Associated Blood Stream Infections (CLABSI) were noted in our unit, Sheryl encouraged the bedside nurses to assess the situation and look for solutions. A unit-based central line auditing system was put into place. This resulted in a dramatic and sustained reduction in CLABSI in our NICU. We are over 30 months CLABSI free! The tools developed by the NICU team have been used in other areas of the hospital with great success.
Change can be very difficult and the time since COVID has been one of incredible change, and challenges both at home and in the workplace for everyone. On the heels of all the rapid and on-going changes to care due to COVID, our unit faced an infection outbreak (not COVID). Sheryl quickly mobilized a multidisciplinary team to identify the infection, potential transmission routes, and identify areas of improvement. This team, led by Sheryl, gathered data, and implemented new protocols and workflows to protect our patients and staff. These new workflows were revised as more information became available. Sheryl and her team were completely transparent with not only our staff; but, also with patient families and our partnering hospitals. She regularly sent updates, held frequent staff meetings with the entire Infection Prevention team available to answer questions, and she has maintained her open-door policy. She truly listened when staff shared their frustrations with the required changes. Sheryl clearly explained the rationale behind the change and empowered the staff to take ownership of these new workflows. There is a saying, “A leader takes people where they want to go; but a great leader takes people where they need to be.” Change can be very difficult, especially on the heels of over a year of dramatic change worldwide. Staff needed transparency, empathy, and stability. Sheryl has provided this over and over. When State agencies met with Sheryl’s team and toured the unit, they were incredibly pleased with all the steps already put into place. The changes implemented by this team have been far reaching, affecting nearly every discipline in the hospital, including environmental services, medical staff, respiratory therapy, radiology, and dietary staff. These changes have had a positive effect on our patients, as we have halted the transmission of the infection.
What further makes Sheryl an exceptional leader is her fierce dedication and her ability to nurture her staff. She always strives to advocate, protect, support, inspire and promote her staff. She empowers staff to problem-solve and encourages implementation of their solutions. Staff recognized an issue with safe sleep practices for our older infants transitioning to home. Sheryl encouraged the bedside nurses to assess the situation and implement solutions. Staffed developed an audit tool, improved bedside practice, and successfully obtained Gold Level National Safe Sleep certification.
Sheryl supports the educational needs of our unit and has allowed our team to create numerous didactic and simulation-based courses. She strongly encourages education through certification and advanced degrees, as well as multidisciplinary collaboration. Sheryl has encouraged many unit-based task forces, such as the NICU Developmental Task Force, the NICU Delivery Room Task force, and the Support U Peer Responder Program, all aimed at improving care of both patient and caregiver. Sheryl’s dedication is not just to our NICU. She has shared her expertise and supported other hospital units in their pursuit of excellence. This includes the University Birthing Suites & Women’s Pavilion in their recent Baby Friendly designation, as well as the Children’s Surgery Center’s re-verification as a Level One Children’s Surgery Center by the American College of Surgeons.
Sheryl supports and collaborates in multidisciplinary research, fostering evidence-based practice. She has been instrumental in our Liquid Gold project, focusing on targeted fortification of expressed breast milk for preterm infants to improve growth and development. Sheryl championed this project which required a sophisticated breast milk analysis machine, a breast milk technician, and a change in the workflow process for the nursing staff. Sheryl strongly encourages innovative approaches to challenges. The NICU has long implemented mucous fistula effluent refeeding to decrease growth failure associated with short gut syndrome. However, the challenges of securing both the appliance to collect the effluent and refeeding catheter to instill the effluent makes this incredibly difficult. A bedside nurse came across a wound care device that was able to meet these needs. Through Sheryl’s support and encouragement, the device was implemented, studied, and resulted in a significant improvement. This changed our practice for our refeeding population. Sheryl further encouraged this nurse to share these results with others in a presentation at a neonatal conference.
When it was identified that families were struggling with the transition from NICU to home, Sheryl championed the creative use of telemedicine in connecting our multidisciplinary neonatal team with the primary care providers and families at their first pediatric appointment. While these video visits are not a billable service, they have resulted in a decrease in length of stay, decrease in readmissions, early recognition of knowledge gaps, and improved parent and provider satisfaction. One family stated, “they made me feel like I was never alone.” This program and its commitment to patient care has been nationally recognized. In 2019, the NICU’s Clinical Nurse Specialist (CNS)was awarded the ANCC Magnet Nurse of the Year and the DAISY award for her role in this research project.
Sheryl’s focus of collaboration across departments and disciplines helped drive the standardized approach to multiple types of neonatal wound and skin care. In 2021, the NICU CNS was the recipient of the National Daisy & IHI Award for Safety. This project resulted in a reduction of post-surgical complications, improved healing, decrease risk of infection as well as a decrease in the length of stay.
Recognizing that the unique and highly specialized care the neonatal patient requires is not covered in nursing school, Sheryl supported the development of a unit-based new hire orientation program. Each new hire receives an individualized assessment and orientation program designed to their own neonatal experience level. For the newly graduated nurse, this program is a 16-week orientation includes hands-on skills stations and classroom education focused on the specialized care of the neonate. During the Level 1 Children’s Surgery Center’s re-verification visit by the American College of Surgeons, the surveyors noted that the orientation program was exceptional. Sheryl has identified coordinators who regularly check in with both the new hires and their preceptors to ensure a successful orientation process. Sheryl invests both time and money into this strong on boarding /orientation process, as the results have paid off with an improvement in patient outcomes as well as nursing satisfaction and retention.
Sheryl truly strives to make a difference not just in our community but globally as well. Concerned about our carbon footprint, she championed our NICU to pilot the hospital recycling program and has supported our units waste reduction program.
Sheryl is an incredible communicator, approachable and available. She maintains an open-door policy which allows staff to communicate with her in real-time regarding challenging situations and concerns. Sheryl maintains a smile and sense of humor, even when she is having a stressful day. She can truly brighten anyone’s day with her animated story telling or infectious laugh. It is a true honor to work with her.
Our unit, which was once struggling and on the verge of collapse, is now a nationally ranked Neonatal Intensive Care Unit. For the last four consecutive years, the NICU has been ranked as one of the US News & World Report Top 50 NICU’s. While she always credits the staff with the success of the unit, our success and our ability to support our community is undeniably the direct result of the environment she has created through her incredible leadership.
Anyone can hold the helm when the sea is calm, but to lead when the seas are rough, to unite a large team and to make a vision not only a shared vision but a reality, that is true leadership.