1 Lauri L. Littleton is a nurse manager at Christiana Care Health System in Newark, Del. Laura A. Fennimore is a professor, acute and tertiary care, at the University of Pittsburgh (Pa.) School of Nursing. Catherine Shull Fernald is the CNO, acute care, at Christiana Care Health System. Judith Zedreck Gonzalez is a professor and DNP program coordinator at the University of Pittsburgh School of Nursing.