By Suzanne Cleere, MSN, MSBA, RN, CENP; Consultant, Creative Health Care Management
Across the country there is a deep desire to elevate professional practice in nursing. It makes me wonder: Do we see the word “professional” as merely a label or does it help to define who we are? The age-old debate on “entry level into practice” surfaces in this conversation. But what I have discovered both in informal conversations and formal assessments in health care organizations across the nation is that even in organizations with a high percentage of bachelor-prepared RNs, there is a deficit of understanding nursing as a profession.
The Importance of Role Clarity
There are multiple strategies that have the potential to awaken professionalism in nursing including work in role clarity. Role clarity helps us to clearly define what it is that is nursing’s alone to own as well as to define the role of each individual nurse in each domain of practice. Within the profession of nursing we have three domains within which we function. They are:
- independent practice (separate from medical practice)
- interdependent practice
- delegated practice (which requires direction/decision making by another discipline)
Until we embrace that which is nursing’s alone to own (which can vary based on State Practice Acts), how can we appropriately enter into collaboration with individuals in any other discipline?
Standards of Practice for Nursing
It turns out that what we own is clearly articulated by the ANA in the ANA Scope and Standards of Practice (2010), along with the ANA Code of Ethics for Nurses with Interpretive Statements (ANA, 2001). Our professional organization provides us with firm ground to stand on and to build on. We own the nursing process. We own who we are in the provision of health care. As defined by the ANA, this is the work of the nurse:
Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations.
Nursing’s boundaries are articulated by the ANA and the State Practice Acts. We are licensed to practice to the fullness of this definition, and we do this through the critical thinking model of the nursing process. Language has risen that describes our unique function, the interventions of nursing care, in Nursing Intervention Classification (NIC, 2013). Additionally we are called to a higher level of professionalism, well described in the 2nd Edition of Nursing, Scope and Standards of Practice:
The Standards of Professional Performance describe a competent level of behavior in the professional role, including activities such as quality of practice, education, professional practice evaluation, communication, ethics, evidence-based practice and research, resource utilization, environmental health, and leadership, appropriate to their education and position. Registered Nurses are accountable for their professional actions to themselves, their healthcare consumers, their peers and ultimately to society. (ANA, 2010)
The scope of nursing practice can be overwhelming unless we take the time to reflect on what it means in our own professional practice environments and in our individual practices.
Questions Useful for Creating Role Clarity
Where do we begin? Clarity requires dialogue. It requires time to pause, to reflect. The first step in creating the role clarity necessary for professional practice to really happen is to ask yourself and your team these questions:
- How do we, in this department or this hospital, live out the standards of professional performance? Are there barriers to living the standards fully?How can I engage in personal professional development?
- Do I (regardless of my role) provide my team with a professional role model?
- Do I (as a leader) provide my team with opportunities to reflect and dialogue on professional development?
- How does my state practice act define my practice?
- Who are the patients we serve?
- What is the intensity of care that this population requires? What aspects of that care are within my independent domain, the interdependent domain, and the delegated domain?
- Who within the team is qualified to provide the care?
When I know who I am in the work, what I am responsible for, and what you are responsible for, we are better together, a stronger team. We raise the level of care given, we improve the outcomes and metrics achieved, and we secure our role and legacy as professional partners in health care.
Reflection and dialogue are valuable first steps in establishing role clarity. Teams seeking further guidance may choose to work with a role clarity expert. The process is comprehensive, and therefore rarely fast, but working with a consultant can ensure that your team does its role clarity work as efficiently and effectively as possible. The most common response I hear from individuals in organizations who commit to the important work of role clarity is that they can’t believe they waited this long to do it!
Fostering connections at work and creating teams have always energized Suzanne, who is a consultant at Creative Health Care Management. She has Master’s degrees in nursing and business administration and is nearing completion of her DNP program, where her capstone project will explore “Reflective Practice: A Mechanism to Improve Relationship with Self, and Improve and Enhance Relationships with Patients and Peers.” All of her academic background is connected to real-world experience: she’s been a leader at every level, from 20-person nursing teams to VP and CNO. In every organization she’s been a force for positive change, leading by example.
Sources
American Nurses Association (ANA). (2001). Code of ethics for nurses with interpretive statements.Silver Spring,MD: Author.
American Nurses Association (ANA). (2010). Nursing: Scope and standards of practice (2nd Ed.). Silver Spring, MD: Author.
Bulechek, G., Butcher, H., Dochterman, J., & Wagner, C. (Eds.). (2013). Nursing interventions classification (NIC) (6th ed.). St. Louis, MO: Elsevier.
By Traci Hanlon MN, RN, Consultant at Creative Health Care Management
Health care organizations are now focused on achieving great clinical and financial outcomes in a value-based culture where service excellence and the patient experience play a significant role in how organizations are being reimbursed. Gone are the days of a fee-for-service culture.
This shift is transforming how health care organizations deliver care, prioritize organizational initiatives, and how we think about the patient experience. Savvy organizations understand there is a positive correlation between financial, clinical, and patient experience outcomes. Leveraging opportunities to become better in all areas using resources already available just makes good sense.
Preceptor Programs are Growing in Importance
It is well documented that preceptor programs have a positive financial return on investment for organizations. A study done by Beecroft et al (2001) estimates that the cost to orient a new graduate nurse is between $39,000 and $65,000 and that 30 percent of them will leave their place of employment within the first year. Fifty seven percent of new graduate nurses will leave within two years.
It is significant to note that poor training and lack of support systems are the main reasons nurses leave within that timeframe. (Patrick, 2000). Preceptor programs bridge the gap from transition to practice and have a positive financial impact on the retention rate of new graduate nurses.
Preceptor Programs and HCAHPS
What is not well studied or documented is the impact preceptors have on improving an organization’s HCAHPS scores.
Did you know that a significant number of preceptors who have been formally educated in precepting, and practice in organizations that have a formal precepting program, reported feeling more prepared to teach, and mentor nurses on practices that have been shown to improve the patient experience?
This qualitative information comes from focus groups I did with nurse educators and preceptors when exploring the influence preceptors have on transition to practice outcomes of new graduate nurses. It makes sense if you think about it. Formal preceptor programs demand the best of the best. Those selected to be preceptors are the individuals who are already engaged and active in culture changing initiatives and have had formal training in adult learning, communication, and the practice of creating healthy work environments.
Improve Care and Improve HCAHPS Scores
Let’s face it; none of us went into health care to improve scores. We wanted to make a difference in the lives of others. It just so happens that when you build healthy environments that nurture self, each other and the patient, scores across the board improve.
Preceptors are the point-of-care staff who role model therapeutic relationships and then as part of their formal teaching role, teach the specifics of how to build and sustain trust with their patients. This is the heart of the patient experience, and if done well, will not only improve an organization’s clinical outcomes, but will also improve HCAHPS scores.
Investing in preceptors and a formal preceptor program is a critical link to improving financial, clinical, and patient experience outcomes. More importantly, it’s the right thing to do for patients.
Traci Hanlon MN, RN is a consultant with Creative Healthcare Management and specializes in preceptor, nursing orientation, and transition to practice program development.
SOURCES
Altier ME, Krsek CA. Effects of a 1-year residency program on job satisfaction and retention of new graduate nurses. J Nurses Staff Dev. 2006; 22(2): 70-77.
Beecroft P, Kunzman L, Krozed c. RN internship: outcomes of a one-year pilot program. J Nurs Adm. 2001; 31 (12): 575-582.
Lindy CN, Reiter P. The financial impact of staff development. J Contin Educ Nurs. 2006; 37 (3): 121-127.
Myrick F, Luhanga F, Billay, D, Foley V, Yonge O. (2012). Putting the Evidence into Preceptor Preparation. Nursing Research and Practice.
Patrick, S. (2000). Managers shoulder burden of retaining staff. Retrieved April 20, 2013, from http://www.bizjournals.com/dallas/stories/2000/08/14/story7.html?page=all
Wolf, J., Palmer, S. (2012). Voices of Practice: Exploring the patient experience in action. Highlights from on the road with the Beryl Institute.
By Susan Edstrom, MS, BSN, RN, Consultant, Creative Health Care Management
I remember vividly my first experience as a patient at age 14, hospitalized for surgery to remove a lump in my breast—I was terrified! Years later, I still remember how I felt with one particular nurse. I don’t recall her name, but I remember her eyes. She saw my fear, and the way she looked at me let me know that everything would be OK. She always knew how to calm me; she allowed me to feel safe and cared for.
She is the reason I became a nurse.
I’ve heard similar stories over the years as I facilitate the three-day program Re-Igniting the Spirit of Caring (RSC). I believe most people working in healthcare are there because they want to help others. In today’s chaotic, task-driven healthcare environments, many staff members are disengaged and suffering from varying degrees of compassion fatigue. I believe this is because people have lost their connection to the core purpose of the work they do. The science of caring is as important to patients as the technical and clinical knowledge and skills we bring. After listening to countless patients relate their personal hospital experiences during the RSC program, not one has reported that a caregiver’s clinical skills are what were most important. In their minds, those skills were a given, and it was the acts of caring that were most important in creating a positive experience for them. Compassionate care promotes healing and helps people feel safe and cope with their illness. Caring is not a “soft skill” and it’s far from optional; it’s what patients tell us they want most.
In my work as a facilitator of RSC, I’ve discovered several practical things that all caregivers can do to reconnect or connect more deeply with their purpose:
- Engage others in conversations about caring. Use appreciative questions at department/unit meetings, reports, and in conversations in the hall. What are the behaviors that demonstrate caring? What do we want care to look and feel like for patients on our unit? What would we want for ourselves or our loved ones? Talk about a time of which you are most proud, when you provided care that you know made a real difference to a patient and family. What were the circumstances? What did it take?
- Dispel the myth that there isn’t time to really care. Compassionate caring is not about time. It’s a mindset that allows us to be fully present to another. It isn’t something more to do; it’s a way of being and a way of doing. In order to cultivate a caring way of being, center yourself before entering a patient’s room while hand washing, by touching the door jam, or taking a deep, mindful breath and committing to really making a connection: “I will be fully present to this person.”
- Sit at the bedside for 5 minutes at the beginning of a shift and really connect. Introduce yourself and explain your role and what you will be doing. Ask the patient “What’s the most important thing I can do for you today?” Really listen and follow up. If you take the time to listen, you’ll save time in the end.
- Incorporate caring for colleagues into daily practices. Start each shift in a staff huddle, having everyone “check in” about how they are today, being aware of who may need help or support. Find ways to affirm and appreciate others’ contributions and acts of caring for patients and colleagues. When we acknowledge and care for one another, it helps us care for others.
- Be impeccable with your language. We objectify people when we use labels, referring to them as “the knee in bed 2,” the “frequent flyer,” or the “demanding family member.” The way we talk about patients affects whether we see them as people.
These are some simple practices that any caregiver can integrate into daily practice in order to help reconnect with the meaning and purpose of caring. The impact they have in helping to create a positive patient/family experience will help facilitate healing, positively influence the patient’s experience, and help keep caregivers focused on what matters most.
Learn more here about measuring and improving employee engagement with HealthStream Employee Insights.
Susan knows how important that commitment to caregiving is; she’s a nurse with more than 30 years of experience as a staff nurse, nurse practitioner, educator, and health care leader. She has a BSN and MS in public health from the University of Minnesota. While she’s no longer providing direct care to patients herself, her goal in her role as a consultant at Creative Health Care Management is to re-ignite a passion for caring in those who do.
By Gen Guanci, MEd, RN-BC, CCRN, Consultant at Creative Health Care Management
I get asked this question or some version of it frequently: “Is a Magnet® journey really worth the time, money, and stress it takes to be successful?” Without any reservation I can honestly say YES! My journey to Magnet® was not as an early adopter. In the early 2000s my CNO announced at a Director’s meeting that we “had applied for Magnet®…and wasn’t that great!”
Getting to Know and Understand Magnet®
At that time I had never heard of Magnet®. Of course everyone in the room agreed with her as we knew it could be career limiting if we did not. But the meeting after the meeting was a different story. My comments to colleagues showed my resistance and were not supportive of this so-called journey we were forced to be on. First, I had no clue what Magnet® was—never mind how much work it might take. I didn’t care about the answers to these questions as I already had too much work to do and so did everyone else.
Co-Leading the Magnet® Effort
Ironically, despite my not-entirely-secret reservations, I was tapped to co-lead the Magnet® Champion group. This was the group of staff who would be the eyes, ears, and voice of Magnet® at our hospital. It was only when I saw how excited the champions were about being empowered in the work place, finally having a voice in decision-making, owning their practice; evolving into professionals, and being able to practice with increased autonomy, did I finally “drink the Kool-Aid.” Since that time I have gone on to support organizations as a consultant as they take their initial designation journey or redesignation journey.
Magnet® Costs and Savings
There is no doubt that a Magnet® journey costs organizations money. Costs can include those associated with the operationalization of professional practice structures and processes including shared decision-making structures, Magnet®-related education, outcome benchmarking database fees, and the fees associated with application, document review, and site visits. But Magnet® expenses are far from being “money out the window.” To offset these expenses, take a look at the potential cost savings associated with decreased vacancy rates. Current industry average to replace a bedside nurse is running around 75% of their annual salary. This figure doesn’t even include the costs to cover that vacancy such as overtime and agency usage. Depending upon salaries in your area, the costs associated with Magnet® Designation could be saved on the backend pretty quickly if you were able to decrease your vacancy rate by 10%. This type of double digit decrease is common for Magnet® designated organizations.
Positive Results from Magnet® Designation
Magnet® organizations also see decreased adverse patient outcomes such as hospital acquired pressure ulcers (HAPU), falls, central line blood stream infections, etc. According to research, one patient fall can add approximately $34,000 to a hospitalization cost. Now imagine if your organization decreased its annual falls by 10…that could be a potential savings of $340,000!
Some ask why it wouldn’t be smarter to just put this money into increasing staffing. Staffing alone does not ensure better patient outcomes. Ownership of data by direct care nurses, as well as RN education levels, has proven to improve patient satisfaction as well as nurse sensitive outcomes. It is a healthy work environment, fostered by a Magnet® journey, that has been proven to improve patient outcomes.
Nurses for years have said we are a profession, and for this blogger, the Magnet® journey has helped raise the level of RN professionalism in every organization I’ve worked with.
So what do you think? Is Magnet® worth it?
Learn how HealthStream can help your facility Accelerate Your Journey for Magnet® Designation.
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As a consultant at Creative Health Care Management, Gen is focused on advancing nursing as a profession and nursing professional development. Whether it’s educating on Relationship-Based Care, helping education departments with structure and competency metrics, or guiding organizations as they establish a culture of excellence, including the journey to Magnet® designation, Gen sees the possibilities in all of her clients. Gen can be contacted at gguanci@chcm.com
By Kenneth W. Dion, MSN, RN, MBA, Vice President and Chief of Nursing Informatics, HealthStream and Mary Smolenski, EdD, APRN, BC, FAANP, CAE, former Director of Certification at the American Nurses Credentialing Center
You can think of an electronic professional portfolio as being similar to an electronic health record. An electronic health record captures all the clinical conditions and interventions over the course of a patient’s life. An electronic portfolio captures all professional development data and supporting documents over the course of a nurse’s career. A professional portfolio—whether electronic or paper— contains a summary of education, licensure, and employment history, just as a résumé does. But a portfolio also contains supporting documents, such as copies of educational transcripts, licenses, and letters of recommendation. Subjective documents, such as case logs and exemplars that show competency, also go in the portfolio, as do narratives reflecting on your nursing practice.
Why an E-portfolio?
In the days of paper portfolios, advocates recommended placing all documents related to professional development in a shoebox. But floods, tornadoes, and other surprises can destroy a shoebox filled with paper in the blink of an eye. An electronic professional portfolio is safe from such natural disasters and, if you regularly backup your files, your portfolio will also be safe from electronic disasters, such as viruses. To create an e-portfolio, scan all important documents that aren’t in an electronic format, including licenses, certifications, and transcripts. Save these documents and those already in an electronic format, including your résumé or curriculum vitae, patient teaching materials, case studies, and reflective documents, on a portable electronic medium, such as a compact disc. Place one electronic copy in a safe deposit box.
Why a web-based portfolio? 
For a more flexible approach, develop a web-based portfolio. Using the Internet allows you to capture professional development data in real time, decreasing the risk that you’ll omit important activities. Capturing data in real time also aids reflective journal keeping and ensures that your information is always up to date. Your web-based portfolio allows you to quickly select information for specific purposes and share it. Just as an artist selects works that are appropriate for a particular show, you can select the professional development activities that are appropriate for a particular event, such as seeking a promotion or new position. Keep in mind that your web-based portfolio is more than a repository of information. It’s a living document you can use to set up alerts and reminders for events, such as licensure and certification renewal. Plus, you can use your portfolio to track your progress on a roadmap, such as a clinical ladder.
Dazzling prospective employers
Today, many institutions and nurse leaders want to develop and maintain a cultural climate of continuing professional competency. When you seek a job in an organization with such a climate, using your e-portfolio will indicate that you are a “cultural fit” and give you an advantage over those who submit résumés.
Renewing your license and certifications
The days of simply obtaining continuing education credit for license renewal are drawing to a close. State legislatures and boards of nursing are taking a fresh look at the processes used to evaluate continuing professional competency. And in several states, one component of a revamped re-licensure process may soon be portfolio evaluation. The International Society of Genetics in Nursing grants certification based on the professional portfolio, and other professional organizations are considering this approach. Professional organizations with limited memberships may replace periodic examinations as a means of renewing credentials with the professional portfolio. Several organizations—including the Wound, Ostomy, Continence Certification group and the Credentialing and Competence Institute—already use portfolios for certification renewal. Using e-portfolios for credentialing review benefits both the credentialing boards and nurses, such as advanced practice nurses. With e-portfolios, both the application process and the ongoing review process become much less burdensome.
Recruiting and retaining nurses
Healthcare organizations also see the benefits of the electronic professional portfolio. Today, many nursing educational programs require portfolios to better position students for employment after graduation. The portfolios allow hiring managers to evaluate candidates by reviewing subjective data in the portfolio, such as case logs and presentations. This approach provides greater insight into the candidate and should result in improved hiring and decreased turnover. Organizations are always looking for retention strategies to lower the cost of nursing turnover. Implementing an e-portfolio system—that is, a single repository for all professional development activities—can reinforce an organization’s commitment to a climate of continuing professional competence and thus improve retention.
Magnet™ recognition and accreditation
A comprehensive e-portfolio system can also help organizations on the Magnet journey. In most institutions, the documents needed for Magnet review are stored in several areas or systems. Pulling the information together can be time-consuming and cumbersome, even when all the information is in an electronic format. Organizations that implement an e-portfolio system greatly decrease the effort needed to gather certain information, such as “highest degree obtained or highest level of degree.” Also, such information is likely to be up to date because each nurse can easily check and correct the information in his or her personal e-portfolio, which feeds the system. As with data needed for Magnet recognition, the data needed for institutional accreditations often reside in several areas or systems. But if an institution has implemented an e-portfolio system, required data can be collected at a surveyor’s request with a few clicks of the mouse.
Teaching by example
Nurse-educators should use e-portfolios for a couple of reasons. First, they are in a great position to demonstrate their commitment to life-long learning by using their own portfolios as examples. Second, educational programs require accreditations, and an important component of the process is a faculty review. Educational programs can achieve the same benefits as healthcare organizations by implementing an e-portfolio system. Educators can also use students’ e-portfolios to make decisions about placing students in clinical settings. Feedback from instructors and mentors at clinical sites should be included in the student’s portfolio. Documentation of experience that might provide course equivalency— significant involvement in the National Student Nurses’ Association, for example—also goes in the portfolio.
Benefits for all
All nurses and the nursing profession can benefit from e-portfolios. Whether it’s a nurse’s individual e-portfolio or a healthcare organization or educational program using an e-portfolio system, the benefits are the same: an ability to quickly and accurately demonstrate life-long learning and continuing professional competence.
Learn More about the HealthStream Professional Portfolio.
Selected references
Bell SK. Professional nurse’s portfolio. Nurs Adm Q. 2001;25(2):69-73.
Corcoran J, Nicholson C. Learning portfolios—evidence of learning: an examination of student’s perspectives. Nurs Crit Care. 2004;9(5):230-237.
Credentialing and Competence Institute. Available at: http://www.ccinstitute.org/cert_cnrc.aspx. Accessed August 4, 2008.
Dennison-Donohoe R. What goes in your professional portfolio and what you’ll get out of it. Am Nurse Today. 2007;2(3):42-43.
Jackson R. Behold the power of the portfolio. Nurs Manage. April 2004;35(Supp1 1):12,14.
Monson RB. Genetics Nursing Portfolios: A New Model for Credentialing. Silver Spring, Md: American Nurses Association; 2005.
Serembus JF. Teaching the process of developing a professional portfolio. Nurse Educ. 2000;25(6):282-287. Wound, Ostomy, Continence Certification Board. Available at: http://www.wocncb.org/recert/. Accessed August 4, 2008.
By Kenneth W. Dion, PhD, MSN/MBA, RN, Vice President and Chief of Nursing Informatics, HealthStream
Greetings from the City of Angels and the Annual American Nurses Credentialing Center (ANCC) Magnet Conference! This year’s conference was attending by over 7,000 nurses and healthcare professionals. The wide variety of topics presented assured that there was something of interest for everyone from staff nurse to CNO.
The Magnet Conference is a Time to Share Strategies and Success Stories
The Magnet Conference is always an energizing event. The atmosphere is so positive and the willingness of attendees to share strategies and success stories is refreshing. It is a great opportunity to catch up with old friends and make new ones. I thoroughly enjoyed having the opportunity to personally welcome long time Decision Critical customers to the HealthStream family.
The HealthStream sponsored Partner Passport program was a huge hit. Thanks to all the attendees who participated. Very special thanks to our partners who played along; America Association of Critical Care Nurses, AORN, AWHONN, AMSN, Sigma Theta Tau International, APIC, Lippincott’s Nursing Solutions and Creative Healthcare Management.
HealthStream Launches Professional Portfolio at Magnet 2012
All of the HealthStream products well received. Clients went out of their way to stop by the booth to tell us how much they enjoy working with HealthStream and how much easier we make their lives. Interest in the HealthStream Professional Portfolio was over the top. Our clients are ecstatic to discover this addition to our offering.
Top Five Tips for Next Year's Magnet Attendees!
If you were unable to attend the Magnet Conference, you were missed. Hopefully we will see you next year in Orlando. For those of you who will be attending for your first time next year, here are the top 5 tips so as not to stand out as a “first timer”:
- Wear comfortable shoes
- Never wait to catch the last bus at the n night party
- Don’t wear too many ribbons on your name badge
- Do fill your bag up with “freebies” on the first day.
- Grab a lunch table early, they fill up fast.
Thanks to the American Nurses Credentialing Center for another fantastic Magnet Conference!
Learn more about Professional Portfolio.
HealthStream is proud to announce our partnership with NICHE, the leading organization designed to help hospitals improve the care of older adults. A program of the Hartford Institute for Geriatric Nursing at New York University College of Nursing, the goal of NICHE is to provide principles and tools to stimulate and support a systemic change in the culture of healthcare facilities to achieve patient-centered care.
We will immediately be offering two HealthStream Live Webinars, which will thereafter be available as online courses accompanied by CE tests that qualify for certificates. In addition to the webinars mentioned below, we plan to offer a steady stream of Webinars from NICHE focused on improving geriatric healthcare.
Geriatric Nursing and NICHE Have Come to HealthStream
We have two upcoming webinars for nurses on geriatric care. For attendees who are not already NICHE member hospitals, you can register through the links below:
Impacting Frailty and Person-Centered Care: Goal Attainment Scaling
In August 2010, Julie Sutherland-Jotcham and Dana McNamara-Morse implemented a pilot program to improve the care of seniors in Soldiers Memorial Hospital's Mayflower unit. Working with residents and the interprofessional team, they introduced the use of the Clinical Frailty Scale © and Goal Attainment Scaling.
Frailty has been shown to have a predictive value, correlating with institutionalization and even death. Goal Attainment Scaling (GAS) is a standardized scoring process by which individualized treatment and goals are measured over the course of treatment/intervention. In this webinar, they will share the Clinical Frailty Scale ©, the research they inspired on the Mayflower Unit, and ultimately the wonderful impact it had in improving resident care.
The Impact of Sepsis on an Aging Population
Severe sepsis is frequently under diagnosed at an early stage when it is still reversible. Increased interdisciplinary collaboration, reduction of variability by use of a standardized screening process, and protocol-directed interventions can help ensure that every patient receives the best care possible. This webinar will discuss the incidence and prevalence of sepsis and the impact on older adult patients. The presentation will also examine the stages of sepsis, the pathophysiology of sepsis and its progression to severe sepsis and septic shock. Early signs and symptoms and subtle indicators of organ dysfunction that herald the onset of severe sepsis in the older adult patient will also be identified. Register for this webinar now to gain an understanding of strategies and treatment considerations for the septic older adult patient.
More webinars, plus the online course versions will be available every month. Check out the HealthStream webinar schedule at http://www.healthstream.com/webinars.aspx
More about NICHE
The NICHE Program provides the principles, resources and tools to stimulate a change in the culture of health care facilities and achieve patient-centered care for older adult patients. It is affordable and comprehensive, and benefits hospitals in a number of ways…
- Improved clinical outcomes
- Positive fiscal results
- Enhanced nursing competencies
- Community recognition
- Greater patient, family, and staff satisfaction
NICHE provides hospitals with…
- State-of-the-art training, tools and resources including an interactive 24/7 E-learning center
- Project management support/mentoring for NICHE-based hospital initiatives
- Evidence-based clinical protocols that address “never events,” Joint Commission compliance and other regulatory imperatives
- Geriatric Institutional Assessment Profile (GIAP) tool
- Shared information, knowledge, and expertise
By Kenneth W. Dion, PhD, MSN/MBA, RN, Vice President and Chief of Nursing Informatics, HealthStream
The word for today is disorientation. And no, I’m not talking about disorientation due to time-zone difference and jet lag. I’m talking about keeping left. As Sigma Theta Tau International moves to embrace its global nature, reflected in both its name and mission, American members like me, who have traditionally comprised the majority, must learn to embrace the cultures and traditions of our global membership. In my case, that means embracing the norms of the wonderful country that is my host for this research congress.
When I say, “Keep left,” I am not speaking politically. I mean, literally, KEEP LEFT! My Australian mates don’t drive on the wrong side of the road, they drive on the otherside of the road. I dare not drive here for fear of putting my life and the lives of my wonderful hosts at risk. This left-sided tendency is not restricted to driving. It holds true for just about anything. The “up” escalator is on the left, not the right, as we “Yanks” are used to. Slow traffic on the walking and bike trails around our host city of Brisbane, and the rest of the country for that matter, needs to move left. So, for those of you I have walked into or just confused, I extend my sincere apologies. I promise that I am working on staying left. And one last note for my friends from the Northern Hemisphere:—Yes, the water really does spin the other way as it goes down the drain. To the left!
A Focus on Nurse Residency and New Nurse Turnover
I knew from looking at the program prior to my arrival that the sessions were organized into tracks or themes. Little did I know that the theme I was interested in—nurse residency and new nurse turnover—would permeate my entire day. During the opening plenary session, Rhonda Griffiths, AM, RN, RM, Bed, MSc (Hons), DrPH, reminded us that policy must be based on valid and reliable evidence, not just the latest research article dragged onto the nursing unit, and that consensus that evidence is truly valid and reliable must be reached before that evidence can inform policy. The limited scholarly research in my area of interest confirmed for me that more study is required before policy can be generated in this area.
Similar Nursing Issues, Global Significance
Following the morning plenary, I visited the poster presentations. Just as there are presentation tracks at this congress that are relevant and timely, so, too, is the diversity of posters. I have no doubt there was at least one poster in the session that any attendee could relate to his or her area of research. My theme for this day—nurse residency and new nurse turnover—continued in the poster session. I found work that aligned with my research interest and confirmed that my interest is of global importance.
I had the honor of moderating a session sponsored by the Sigma Theta Tau International Foundation for Nursing. During this session, I learned about fantastic work being done by nurse scholars that found its genesis in a small research grant funded by the Honor Society of Nursing, Sigma Theta Tau International (STTI), as well as research that received continued funding through STTI, which increased its validity and reliability. The thread continued to weave its way through my day.
Conference Photo: Recipients of Leadership Education Grants
I am proud to serve on the foundation’s board. One of the most rewarding parts of that service is meeting nurse scholars and future nurse scholars who have benefited from a foundation Leadership Education Grant. These grants allow members who might not otherwise be able to attend events, such as this congress, to come learn, network and, above all, contribute to nursing scholarship. The first-ever networking event for recipients of these grants was held at this congress. This event allowed not only me but also the sponsors of these grants to meet these truly deserving recipients...
Kenneth W. Dion, PhD, MSN/MBA, RN, founder and chief executive officer of Decision Critical, Inc., a software company that specializes in learning and competency management products for acute-care hospitals, is now vice president and chief of nursing informatics of HealthStream, following HealthStream’s recent acquisition of Decision Critical. Dion is also president of the board of trustees of the Foundation of the National Student Nurses’ Association and serves on the board of directors of Sigma Theta Tau International Foundation for Nursing.
Prepare for the Impending Nursing Shortage Before It's Too Late
Approximately 3 million Nurses make up the single largest segment of the healthcare workforce in the US and spend the greatest amount of time delivering patient care as a profession. However, there are significant barriers preventing nurses from being able to respond effectively to rapidly changing health care settings and an ever-evolving health care system. These barriers need to be overcome to ensure that nurses are well positioned to lead change, and advance patient health. Valuable insight from this group plays a critical role in the transformation of the nursing profession, and could lead to a marked improvement in the quality and safety of care in the US.
An Effort to Assess and Transform the Nursing Profession
In 2008, The Robert Wood Johnson Foundation (RWJF) and the Institute of Medicine (IOM) launched a two-year project to report and respond to the need to assess and transform the nursing profession. The IOM appointed the Committee on the RWJF Initiative on the Future of Nursing, and the resulting report was designed to serve as:
- A framework for changes in the nursing profession and the health care delivery system
- Direction to individual policy makers, national and state local government leaders, payers, health care researchers, executives, healthcare professionals, licensing bodies, education institutions, and advocacy organizations
Recommendations for the Future of Nursing
The objective of this report was to develop action-oriented recommendations for the future of nursing to lead change and advance health, which included the following four key messages:
- Nurses should practice to the full extent of their education and training.
- Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression.
- Nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the United States.
- Effective workforce planning and policy making require better data collection and information infrastructure.
Attend Our Webinar About the Future of Nursing and Handling the Nursing Shortage
We are excited to announce a new HealthStream LIVE! webinar that will address the IOM's report on the Future of Nursing in detail.
Dean of the Oregon Health & Science University, published author and member of the Institute of Medicine (IOM) committee on the Future of Nursing Report, Michael Bleich PhD, RN, FAAN will share the key findings from this report on July 31, 2012. He has published more than 50 articles, book chapters, and monographs on the topics of leadership, academic–service partnerships, and workforce supply and demand; two chapters were in books that were named the American Journal of Nursing Book of the Year.
SimCenter in the News
HealthStream's joint venture with Laerdal Medical, SimCenter, has been featured significantly in recent media. The following feature stories focus on the SimView™ and SimManager™ launches, along with product news. Notable mentions below include news from MarketWatch, medGadget, InformationWeek, Green Technology World, Chief Learning Officer, Investor’s Business Daily, and Today in PT Magazine.
Highlights Below:
MarketWatch, 31 January 2012
“HealthStream and Laerdal Medical Launch SimManager(TM), a Comprehensive, Easy-to-Use Application for Managing Healthcare Simulation Education Programs”
medGadget, 31 January 2012
“HealthStream and Laerdal Unveil New Clinical Simulator Management Tools”
Information Week, 3 February 2012
“Mannequins Recruited To Teach Medicine”
Green Technology World, 3 February 2012
“HealthStream and Laerdal launch SaaS application for simulation-based training”
Chief Learning Officer Magazine, 1 February 2012
“HealthStream and Laerdal Medical Launch Application for Managing Education Programs”
Investor’s Business Daily, 15 March 2012
“HealthStream Takes Medical Training Into The Cloud”
HealthStream and Laerdal have combined our experience and knowledge to make simulation easier. With SimCenter, we are removing many barriers to adopting and integrating simulation into current curricula. It combines curriculum delivery, learning management, debriefing, and competency assessment in a single, fully-integrated platform. SimCenter, which can be purchased as separate components or a single solution, improves orientation of new hires and continuing education for experienced employees, while creating a more efficient process for evaluating staff competencies. By using validated content from industry leaders and delivering it in a usable, manageable format, simulation is truly made easier. SimCenter is a tool that can be used to complement current educational programs and support educational objectives.
Learn More about SimCenter and Medical Simulation Training Here.