Expanding Procedural Comfort Initiatives and Self-advocacy from Pediatrics to Adult Care Settings

Michelle Churches is a Clinical Affairs Staff Specialist for the Office of Clinical Affairs Accreditation and Regulatory for Michigan Medicine in Ann Arbor, Michigan. Michelle received her undergraduate degree from Wayne State University and her MSN in Health Systems Leadership graduate degree from Gonzaga University. Churches has practiced pediatric nursing for over twenty-five years and has been involved in pain management, quality improvement and evidence based practice changes. She has participated in the development of the individualized procedural plan in pediatrics and is part of the implementation team leading education to bring this initiative to the adult care settings in ambulatory and inpatient settings at Michigan Medicine. Churches was a nurse lead for support in development of nursing guidelines for Procedural Pain and Anxiety Management. She was a team lead at Kellogg Eye Center at Michigan Medicine for the implementation of the Poke Plan in the adult ophthalmic patient population. Churches has worked in emergency medicine, ambulatory care settings, inpatient and perioperative areas for adult and pediatric patients. She utilized her change management knowledge and experience to support quality and safety initiatives and now continues to work to support strategies and education for Michigan Medicine’s Office of Clinical Affairs to ensure accreditation and regulatory compliance across the enterprise. Improved patient experience is always her goal.

Nancy Deeb is a patient/family advisor at Michigan Medicine at the University of Michigan and is on the comfort initiatives team to roll out the Poke Plan institution wide. She has experience being a patient at Michigan Medicine as well as a parent of a patient, spouse of a patient and daughter of a patient. Nancy has a B.S.N. from the University of Michigan. She worked in nursing at The University of Michigan as a floor nurse, ICU nurse, nursing administrator, outpatient nurse, and clinical research coordinator. She is currently retired.

Sandra Merkel was Clinical Nurse Specialist for the Pediatric Acute Pain Service at C.S. Mott Children’s Hospital and an Adjunct Nursing Instructor at the University of Michigan in Ann Arbor, Michigan. Sandra received her undergraduate degree from the University of Iowa and her graduate degree from the University of Michigan. Merkel has practiced pediatric nursing for over forty years and has been involved in pain management, quality improvement and evidence based practice changes. She and colleagues developed and validity the FLACC pain assessment tool which is utilized by clinicians throughout the country and world. Merkel has also participated in the development and revision of two position papers for the American Society of Pain Management Nursing. Merkel was the nurse lead in the development of the Poke Plan and develop of nursing guidelines for Procedural Pain and Anxiety Management. She was the project coordinator for the implementation of the Poke Plan in the adult ophthalmic patient population. After retirement Merkel continues to work with Pain Management Nursing and participates in the strategies and education for Michigan Medicine’s health system’s Poke and Procedure Program.

A Certified Child Life Specialist for over 30 years serving both pediatric inpatients and outpatients and their families in a large university teaching hospital, Julie Piazza has collaborated with multidisciplinary teams to facilitate patient and family centered initiatives hospital and system wide, many of these initiatives have been related to reducing pain and anxiety with needlesticks and procedures. An educator for medical and nursing students, Julie has served as an adjunct professor and guest lecturer for the child life degree program and residential colleges at three local universities. Julie has presented at several regional, national and international conferences for: child life, community partnership, innovation, healthcare informatics, social work, pediatric anesthesia, pain management, quality improvement, leadership, science and technology, and patient family centered care.
Areas of Expertise:
• Pediatric Pain Management
• Teambuilding and Leadership
• Patient Family Centered Care
• Healing Environments
• Community Partnerships
• Staff Development: Training, Mentoring & Leading
• Creating and Telling the Story
• Therapeutic Interventions
• Respite and Comfort Initiatives across the Age Span

Credentials: MS BS CCLS Degree: Masters of Science Year: 1984
School: Wheelock College Major: Children’s Health Care Administration
Degree: Bachelors of Science Year: 1981 School: Iowa State University Major: Child Development
Child Life Certification: 1987-2022 Contact Information: julipiaz@med.umich.edu julipiaz1@gmail.com 734-368-2907 mobile