Nancye B. Holt Legacy of Nursing Excellence Award
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Award Nomination Form for Professional Registered Nurses
The purpose of the Nancye B. Holt Legacy of Nursing Excellence Award is to recognize a professional direct care nurse who exemplifies the hallmarks of rehabilitation nursing practice.  Nancye B. Holt was a pioneer in rehabilitation nursing setting standards of practice and creating a legacy of professional nursing distinction at the Rehabilitation Institute of Chicago. The award winner will be announced during Nurses Week 2019, May 6th through 12th.

Please submit at least one paragraph telling a story about a
nurse who lifts spirits and touches lives in practice.  
Please be specific to give your nomination the best opportunity for consideration.

Characteristics of Professional Nursing Excellence:
- Exemplifies our Mission & Philosophy in patient care, education, research, community service, and advocacy
- Demonstrates leadership skills with the team and makes complex decisions that are data driven or evidence based
- Prescribes, delegates, and coordinates nursing care
- Critically assesses patients’ actual or potential health problems
- Utilizes the nursing process to set goals and identify outcomes
- Assists the individual with a disability in restoring, maintaining, and promoting his or her maximal health
- Treats alterations in functional ability and lifestyle that result from physical disability and chronic illness
- Applies customer care principles always putting the patient first
- Evaluates a patient’s response to specific interventions and modifies plan of care
- Coordinates and collaborates with the interdisciplinary team, patients, and families
- Develops a discharge plan that provides for continuity of care
- Utilizes innovative approaches to care delivery
- Assists in developing “best practices” and advancing rehabilitation nursing care
- Serves as a role model, mentor, and coach to promote a positive milieu for nursing staff and patients

ANY STAFF MEMBER, PATIENT, OR FAMILY MEMBER MAY SUBMIT ONE NOMINATION

Nominations are due by 5:00 PM on Tuesday, April 2, 2019.
Thank you.

Nominee’s Name: *
Nominee’s Primary Unit or Team: *
Tell us why your Nominee should receive this award *
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