HOME CARE & HOSPICE CLINICAL 2-4 NURSING PROCESS 2 CLINICAL COMPETENCE 3 MANAGEMENT OF THE CONTINUUM OF CARE 4

HOME CARE & HOSPICE CLINICAL 2-4 NURSING PROCESS 2 CLINICAL COMPETENCE 3 MANAGEMENT OF THE CONTINUUM OF CARE 4 LEADERSHIP 5-7 DELEGATION 5 COLLABORATION 6 MANAGEMENT OF ENVIRONMENT 7 PROFESSIONAL DEVELOPMENT 8-9 MENTOR/PRECEPTOR 8 KNOWLEDGE SEEKER 9 QUALITY/EVIDENCE-BASED PRACTICE 10 QUALITY IMPROVEMENT 10 PROFESSIONAL IDENTITY 11-12 PROFESSIONALISM 11 COMMUNICATION 12 APPENDIX Application Checklist 13 Weighted Criteria: Unless clearly defined as points per event or activity or include a maximum, weighted points represent the maximum points for each criterion listed. 2001 Loyola University Health System Home & Hospice Criteria Page 1 of 13

CLINICAL: NURSING PROCESS* Completes basic, initial and ongoing assessment focused on chief complaint. Assesses equipment in use. Actively seeks assistance to verify assessment and changes noted. Recognizes subtle changes in ongoing assessment even when unrelated to chief complaint and seeks validation through consultation. Identifies problems & documents a plan related to chief complaint & additional areas requiring interventions. Contacts physician to initiate prescription of orders seeking assistance when the relationship between the assessment and the orders is unclear. Carries out interventions that are defined in policy or individual plan of care. Seeks verification that actions/reporting is appropriate. Documents assessment, intervention and patient responses. Evaluates interventions against desired goals. Seeks appropriate changes. Aware of ethics consult service and the mechanism of making a consult. Utilizes history and environmental clues (i.e. medications, foods) to complete initial and ongoing assessment of all related areas. Reports assessment findings/ changes. Is a resource to others related to unique knowledge. Identifies & documents plans related to problems, potential problems & areas requiring intervention. Pursues verification of assessment/treatment plans until plan is consistent with assessment (i.e. physician, respiratory therapist, charge nurse) Plans and coordinates interventions appropriate to patient needs and to meet goals for immediate & longterm management. Discontinues interventions or advances interventions in response to patient condition changes. Plans additional or alternative interventions in response to evaluation. Addresses goals with multidisciplinary team. Discuss patient care needs in relation to ethical considerations. Identifies & documents plans that reflect individualization of plan incorporating family participation. Assesses and implements orders in light of complete patient situation. Anticipates next steps and collaborates in developing plans of care with multidisciplinary team. Utilizes critical thinking skills to make independent decisions to enhance patient state of health or ameliorate chronic conditions. Assesses desired goals to redefine expected and desired outcomes. Assesses/explores patient care situation to develop complete picture of patient and family in light of ethical considerations. Articulate and responds to subtle and non-specific changes in assessment based on factual knowledge and intuition. Educates others from knowledge & experience of physiologic/clinical outcomes. Develops and implements interdisciplinary plans of care for classes of patients to be utilized and individualized by others.** (WEIGHTED 4 pts) Educates and consults with colleagues to develop their assessment skills in context with the patient s complete situation. Creates customized interventions for complex problems using successful solutions in new combinations. Identifies trends and issues through evaluation of individual patient s care and applies learning to care of specific patient populations. Consults and/or validates peers exploration of ethical discussion. Encourages ongoing discussion of ethical issues *For new applicants or those seeking a higher level, one paragraph demonstrating your planning and critical thinking skills while dealing with a difficult or challenging patient, organizing a discharge or planning care for a new admission. *Clinical log, from a minimum of eight months, which document specific events (must include specific date of event) to demonstrate clinical, leadership and overall performance at the level for which you are applying. Additional entries documenting specific events may be used to validate required and/or weighted criteria, however, meeting and in-service attendance do not represent clinical activities for this requirement. ** Include plan of care. 2001 Loyola University Health System Home & Hospice Criteria Page 2 of 13

CLINICAL: CLINICAL COMPETENCE Provides nursing care that follows policies and procedures, maintains patient safety and provides care in accordance with the nurse practice act. Knowledgeable related to policy and procedures, program specific guidelines, equipment, and meeting patient needs by utilizing established systems. Suggests program-specific changes to enhance effectiveness. Initiates change in policies, practices and standard of care based on clinical judgement and care. Coordinates change in policies, practices and standard of care in response to evidence based information. Participates in the communication of these changes. Demonstrates understanding of anatomic and physiologic rational for interventions. Requests observation of skills and evaluation of skills to gain competence in program specific skills. Seeks opportunities to develop technical skills and use specific equipment. Demonstrates program competencies. Knowledgeable in using equipment of patient care and recognizes malfunction, takes the equipment out of service and reports appropriately. Consults with Coordinator/ Manager in response to patient s or family s unique requests and needs when concerned about ability to meet them. Explains rationale for interventions. Answers questions and seeks assistance when question is outside of knowledge base. Demonstrates competence in program-specific technical skills with consistent attention to detail and accuracy. Able to supervise technical skills to assist peers in developing basic competence. Identifies skills, questions that may be appropriate for competency assessment. Identifies equipment malfunction and follows through system to repair or replace for patient care. Adapts plan of care and interventions to reflect patient s/family s unique requests and/or needs. Manages pace of activities in routine patient assignment. Thorough knowledge base related to multiple patient populations. Utilizes experience and knowledge to anticipate potential patient care issues. Functions as a resource to colleagues in answering questions.** (WEIGHTED 1 pt/5 pts Max) Technical expert in skills appropriate to patient populations. Individual sought to carry out technical skill when others are unsuccessful or in difficult situations (i.e. IV, ostomy, pumps, wound care, nebulizers). Teaches colleagues skills appropriate for program.** Participates in evaluating peers in completing program competencies outside of the preceptor role. Provides feedback to the manager.* (WEIGHTED 2 pts/6 pts max) Recognizes optimal use of equipment, appropriate interventions for unusual events or rarely done procedures and is a resource to colleagues outside of the preceptor role.** (WEIGHTED 1 pt/max 3 pts) Incorporates patient s or family s unique cultural, spiritual customs and rituals into plan and schedule of care. *** (WEIGHTED 1 pt) Manages pace of activities to deal with unusual demands of patient or situation. Directs patient care and demonstrates extensive, current knowledge base in area of specialty. Leads discussion of care with multidisciplinary team. Creates solutions that use knowledge and experience in new ways for unique clinical situations. Identifies new skills and techniques to enhance care for a patient population. Develops and implements program competencies in collaboration with the manager/educator.* (WEIGHTED 5 pts/year, you may qualify for level 3 or level 4 pts only) Identifies new equipment that provides enhanced effectiveness and efficiency. Seeks resources to assist peers in understanding and responding to patient and family s unique cultural, spiritual customs and rituals.*** (WEIGHTED 2 pts) Gains and maintains unique skill or knowledge base and is an available resource to peers in specific clinical situations as a result. (i.e. LVAD discharge, PICC placement).**** (WEIGHTED 5 pts/10 pts max) * Acknowleged in manager letter or letter from Nursing Education and Support defining which competencies were evaluated for level 3 points and a copy of competency developed and implemented for level 4 points. **Clinical Log entries that cite specific events (1 pt per event) to demonstrate knowledge/skill. ***Documentation of activity or resource and peer response as a result. ****For unit specific unique knowledge provide a description within the log explaining what makes knowledge/skill unique with a minimum of 3 specific examples in your clinical log that demonstrate assisting peers with this knowledge. This is to be sure the reviewers who are unfamiliar with your practice site understand your knowledge. System wide unique knowledge (i.e. Rapid Response Team) do not need a paragraph, demonstration of participation is sufficient. 2001 Loyola University Health System Home & Hospice Criteria Page 3 of 13

CLINICAL: MANAGEMENT OF THE CONTINUUM OF CARE Completes appropriate activities to admit a patient. Completes appropriate activities to transfer a patient to a different care program, care setting or to discharge a patient. Provides specific instructions for this visit to assist patient/family in self-care between visits. Utilizes patient and family education tools. Provides support to patients and families related to the stress of current health status. Listens fully to patient/ family share information found on internet and refers to appropriate colleague when unsure of information or appropriate action. Identifies discharge issues from first visit with patient and coordinates with internal resources, i.e. Rehab services, Social Worker, Pastoral Care, etc. Coordinates ambulatory visit/visits to maximize efficiency for patient. Integrates multidisciplinary plans into patient plan of care and schedule; prepares patient for tests/procedures physically as well as with information/education. Coordinates teaching to foster patient/family s ability to independently provide care with confidence including care needed between visits. Provides feedback as to content of patient and family education tools. Provides information and support to assist patient/ family in anticipating disease and recovery course. Responds to patient/ family use of internet as health information source by referring to appropriate sites, providing education to validate or correct information. Uses Loyola Intranet resources for teaching. Identifies and initiates referrals for appropriate resources/ programs within the Loyola University Health System and community resources. Coordinates ongoing care with all resources to meet goals. Develops and implements plan to progress patient to next level of function. Involves patient s resources, i.e. family, support network, in care and follow-up plans. Coordinates and provides anticipatory and complex education and assists family in planning for care activities and future activities related to illness including between visits. Revises existing patient and family education tools and submits to Patient Education Committee.* (WEIGHTED 2 pts/4 pts max) Anticipates the patient s disease course and adapts to changes in the patient s situation. Utilizes electronic databases to investigate practice issues.*** (WEIGHTED 1 pts) Evaluates effectiveness of referrals to include assessment of their ability to assist with long-term care needs of client including transition when home care services are discontinued. Consults with and educates peers in progressing patients to the next level of function. Coordinates the multidisciplinary team by leading care conferences, including consult services and communicating plans with all providers. Directs and consults with other members of the healthcare team on the provision of education to specific patient populations. Develops patient/family education tool and submits to Patient Education Committee.* (WEIGHTED 3 pts/6 pts max) Implements education tool once approved.* (WEIGHTED 1 pt/2 pts max) Advocates care in relationship to family dynamics and current medical situation. This may include orchestrating extent of care or end of life discussions.** (WEIGHTED 2 pts/4 pts max) *Copy of education tool, and dated submission verification letter, approval letter once approved and date implemented. All steps include verification of your role in revision/development. **Clinical log entries that are co-signed by the manager/director of the department. ***Copy of internet database search with explanation of how you used the information. 2001 Loyola University Health System Home & Hospice Criteria Page 4 of 13

LEADERSHIP: DELEGATION Delegates tasks to ancillary staff and/or identified care giver in the home. This includes assigning responsibilities to the ancillary staff or other care giver, evaluating completion of tasks, providing education, feedback and coaching to complete tasks. Assists peers in dealing with a difficult or rapidly changing assignment. Identifies and communicates problems to the appropriate person. Identifies potential solutions to problems. Functions in role of charge nurse managing department activity for a shift and managing patient visits. Able to coordinate activity of staff to meet patient crisis. Maintains a calm presence in emergency situations. Initiates identified solution and communicates occurrence to appropriate persons. Consistently consults with peers to assist them in dealing with complex situations when the peer is in charge. In complex or multiple emergency situations determining appropriate action and directs staff. Recognizes and initiates actions to ameliorate emergency situations. Utilizes knowledge and information to decrease peers, patients and families anxiety. Effectively manages rapidly changing situations to match demands with available resources. When needed, recognizes essential activities from activities that may be delayed or deferred. Supports follow through related to implemented solution. Evaluates implementation. Orients others to the role of charge nurse.** (WEIGHTED 1 pt/ person; maximum 3 pts) Utilizes additional resources for emergency or crisis situations, such as administration, attending physicians, legal or risk management, patient relations. Leads response to internal disaster situations, contributes to policies guiding disaster response. *Manager letter must note participation in this role. A list of staff you oriented to charge including dates of orientation 2001 Loyola University Health System Home & Hospice Criteria Page 5 of 13

LEADERSHIP: COLLABORATION Seeks assistance when increase in activities challenges ability to complete work. Organizes and prioritizes patient assignment including handling unexpected changes. Organizes assignments of visits to facilitate patient care within program. Manages multiple demands including several patients, family issues, own assignment and Develops organization/ prioritization skills. Demonstrates flexibility related to scheduling, family schedules and assignments. Focuses on completing tasks of own patient assignment within scheduled timeframe. Recognizes and utilizes patient/family strengths to collaborate in optimizing care for the patient. Provides assistance to peers when activities change. Cooperates with other staff in problem solving. Flexible; able to adjust assignment to reflect changes in work load including own schedule of visits for the following day. Advocates for patient and family with physicians, payers and community agencies to optimize care. Learns from family effective care alternatives. Assists others proactively demonstrating cooperation and respect. Implements ways to alter work assignments to meet changing patient needs of patients in entire program. Advocates for patient and family within family system to optimize care and family coping. Utilizes available resources to assist. program activities. Resourceful in problemsolving unusual situations and is the colleague others consult to problem-solve. Supports peer s development by assisting rather than responding by doing for peers. Prioritizes care in complex situations and projects problem solving to include planning for the next day s visits utilizing resources to manage to productivity standards, minimizing overtime and agency. Utilizes nursing expertise to enhance patient care and outcomes beyond own site, department or nursing unit. * (WEIGHTED 5 pts) *Include a paragraph defining the project or what you did to enhance patient care and outcomes beyond your own department. Have the paragraph cosigned by your manager or the person authorizing the project. 2001 Loyola University Health System Home & Hospice Criteria Page 6 of 13

LEADERSHIP: MANAGEMENT OF ENVIRONMENT Maintains policies and Adapts to unfamiliar Educates peers or develops regulatory compliance to environments of care and learning opportunities on on provide a safe autonomous situations to safety/ techniques related to environment for patients create aseptic/therapeutic new procedures, new products and/or new I.T. and self (i.e. car safety, environment of care that systems outside of the role of bag technic). maintains personal, patient and family safety. preceptor.* (WEIGHTED 1 pt/3 pts) Functions as a resource for technical skills or knowledge for colleagues in other departments, i.e. with equipment, etc.** (WEIGHTED 1pt/ event; Develops awareness of equipment available for emergency situations in use of equipment. Respectful of staff and patients. Identifies needs/issues related to maintaining a safe environment for necessary care. Maintains readiness of emergency and specialty equipment. Gains maximum support for patient care through system. Carries out activities of product evaluation. Identifies situations of conflict with patients, families or team members and seeks resources and suggestions to facilitate situation. Teaches families related to maintaining a safe environment for necessary care. maximum 5 pts) Anticipates potential emergencies for patients and prospectively notifies appropriate authorities. Consults with colleagues as to what support is available to assist in specific patient care situations. Participates in new product implementation. *** (WEIGHTED 2pts) Anticipates situations of potential and actual conflict with patients, families or team members and seeks resources or suggestions to minimize actual conflict. Negotiates with families in difficult or resistant circumstances to create a safe environment for necessary care. Resource to peers in dealing with potential or actual emergencies with patients. Develops relationships with other departments and vendors to assure support for patient care. Coordinates the clinical involvement of a product evaluation to include involving peers and gather feedback data.**** Intervenes in situations of potential or actual conflict to defuse situation. Provides suggestions drawn from experience to assist peers in developing conflict management skills. Consults with or directs peers in identifying irresolvable environments to relocate care into a safe environment. *Clinical Log entries citing up to three specific events where you provided these learning opportunities. **Clinical Log entries that describe specific events to demonstrate participation as a skill or knowledge resource to departments outside of your own unit. This may not be one to which you are cross-trained and for which you are seeking weighted points. ***Committee letter from manager or Value Analysis Team (VAT) chairperson or Medical Economics Outcomes Committee (MEOC) chairperson defining your role in implementing a new product. ****Documentation in manager letter of involvement in coordinating a clinical evaluation of a new product. 2001 Loyola University Health System Home & Hospice Criteria Page 7 of 13

PROFESSIONAL DEVELOPMENT: MENTOR/PRECEPTOR Identifies developmental Evaluates level 1 nurses Evaluates level 2 nurses Evaluates level 3 nurses needs and initiates steps to and provides professional assisting them in reaching assisting them in reaching move to level 2 within 18 encouragement to advance level 3.* level 4.* months. to level 2. (WEIGHTED 1pt/RN accepted (WEIGHTED 1pt/RN accepted at level 3; max 3 pts/yr) at level 4; max 3 pts/yr) Mentors peer to become nationally certified or achieve first renewal of national certification.* (WEIGHTED 1 pt/rn; Max 3 Evaluates own learning needs, seeks information and/or assistance when faced with situation beyond current knowledge. Introduces self to staff members they do not know within the department. Precepts new staff and /or students providing observation of skills. Shares clinical knowledge, rationale for interventions and answers questions for peers. Welcomes new staff by introducing themselves and orienting them to the environment of the unit. Available resource to staff outside of department/ specialty area related to unique knowledge base. Works with students who are assigned to your department for a clinical experience. Functions as mentor and shares secrets, successful interventions with rationale willingly without intimidation. Socializes and nurtures new staff into unit. Functions as a consistent relief preceptor, working a minimum of 72 hours with orientees in the absence of the primary preceptor.** (WEIGHTED 1 pt/72 hours to a maximum of 3 pts) Able to teach staff within or outside of department/ specialty area to enhance their understanding and ability to critically problem solve similar situations in the future. Mentors other professional students (i.e. Medical students, Resp Therapy students, etc). Must mentor a minimum of 24 hours in past year. **** (WEIGHTED 1 pt) Participates in health or professional promotion related activities. (i.e. health walks, fair, donating blood, advisory council) 2 hrs of flu vaccination or 2 hrs of employee health fair = 1 event. (Weighted 1 pt per event/max 3 pts)***** pts/yr) Maintains awareness of new staff learning needs and provides support/ opportunities to maximize learning. Assists new staff in developing relationships and meeting resource people beyond those in the immediate program. Coordinates entire orientation of new staff by seeking to facilitate appropriate learning experiences to advance knowledge and skill development and meet weekly goals.** (WEIGHTED 5 pts/year you may qualify for level 3 or level 4 pts only) Enhances orientation by developing or bringing in new material to orientation, updating materials.*** (WEIGHTED 2 pts) Mentors a nursing student for the senior role transition experience of 120 clinical hours or equivalent student precepting.**** (WEIGHTED 2 pts. Students requiring 80-119 hours = 1 pt) Plans or leads a health related community outreach activities such as health fairs, lectures, nurse recruitment etc. Or participates on own time in a mission trip that uses nursing skills and knowledge as part of the trip. *Letter from peer clarifying your role in assisting them in reaching level 3 or 4 with a copy of the peers acceptance letter or national certification within the year they achieved this level or national certification for the first time or first renewal of national certification. **A list of orientees whom you precepted with dates of precepting activities and verification on your manager letter clarifying your role in orientation. ***Inclusion in the Manager letter or verification from preceptors on unit to support participation in updating of orientation. ****Faculty letter, if received, for role transition student. Clinical log entry signed by non-rn student or inclusion in manager letter for non-rn student. *****Verification of participation from sponsoring agency or equivalent. 2001 Loyola University Health System Home & Hospice Criteria Page 8 of 13

PROFESSIONAL DEVELOPMENT: KNOWLEDGE SEEKER Acquires and maintains instructor level in basic certification. BLS* Acquires and maintains basic certifications as required for patient populations (i.e. BLS, NALS, PALS,ACLS). Seeks information from internal experts to enhance patient care and professional development. Seeks experiences to develop clinical knowledge base and technical skills. Attends department-based in-services. Reads posted material in unit and responds by changing practice to reflect current evidence. Attends nursing grand rounds. Recognizes continuing learning needs and seeks opportunities through education and clinical situations to gain knowledge. Participates in 6 health system wide non-mandatory educational activities in the past year (posted articles may be included). 6 CEs in addition to level 3 required may be used. Participates in journal club. Participates in cross training to broaden competence to more than one program.** (WEIGHTED 5 pts) Obtains a minimum of 16 CEs in the past year or Nursing coursework equivalent (See Resource Guid for calculation of equivalents.). Cannot use mandatory CEUs or inservices. Certificates of attendance required. Provides in-service education as instructor that has been developed by peer, Education and Support Services, etc. or leads a journal club.*** (WEIGHTED 2 pts/each inservice provided/maximum of 6 pts)) Participates in presenting nursing grand rounds or other programs offered to a broad Loyola audience. (WEIGHTED 3 pts/ presentation) Seeks or has a bachelors degree in nursing.**** (WEIGHTED: 1 pt for having degree, 3 pts if attending school this year, 5 pts if graduated this application year) 2001 Loyola University Health System Home & Hospice Criteria Page 9 of 13 Acquires and maintains instructor level in advanced certification.(acls, PALS, NRP etc)* (WEIGHTED 4 pts/ certificate) Function as organizing faculty for PALS or ACLS (specific site, unit, or department). This is in addition to teaching for the training center.* Attains and maintains national benchmarked advanced certification in nursing specialty. (WEIGHTED BY CERTIFICATION LIST maximum 2 certifications; 0 pts for level 4 required certification) Maintains competence by practicing regularly in two programs or with two specialized populations. ** WEIGHTED 5 pts/year may qualify for level 3 OR level 4 pts only) Responds to articles, experience and educational offerings by incorporating new practice and providing education, policy input to alter program-wide practice. Develops and presents in-services education for unit.*** (WEIGHTED 4 pts/each in-service developed/maximum 8 pts) Provides developed in-service for a different department. (WEIGHTED 1 pt/year) Develops or leads staff group in preparing and presenting nursing grand rounds or other programs offered to a broad Loyola audience. (WEIGHTED 4 pts/ presentation) Seeks or has an advanced degree in nursing. **** (WEIGHTED: 2 pts for having degree, 3 pts if attending school this year, 5 pts if graduated this application cycle) *Letter from LUMC Training Center validating a minimum of 4 sessions taught at LUMC in past 2 years. Include faculty role if applicable. Only classes taught for Loyola Training Center count toward weighted criteria. **Completed annual skills lab from alternate program and Manager s letter from alternate program ****Objectives and outline or handouts of in-service given with verification from manager, educator of your participation in developing and/or implementing education. These points are for in-service developed by applicant. A developed in-service may be presented several times without additional points. 1 additional point may be obtained by presenting to a different department or unit. *****Include a copy of diploma or final transcript for having degree. Report card listing courses taken in this past year if attending school. For 5 pts, copy of diploma with graduation date this past application cycle. To utilize for Des and weighted points must have 1 course beyond what is needed for CEs. For units where ACLS, PALS, and/o NALS are required, these courses may not be utilized for CEUs.

QUALITY/EVIDENCE-BASED PRACTICE: QUALITY IMPROVEMENT Identifies components of the PDCA cycle. Explains PDCA cycle to new orientees, peers. Utilizes PDCA cycle in project coordination. Participates in LUMC Quality, nurses week or Safety Fair.* (WEIGHTED 1 pt) Develops quality storyboard for LUMC Quality or Safety Fair.* (WEIGHTED 2 pts) Aware of quality improvement initiatives in unit and across health system and seeks to incorporate information from projects into practice. Reads nursing research and quality articles posted on unit. *Participant certificate. Participates in quality data collection for unit. Participates in unit meetings, committees and task forces to improve care. Provides care with consideration to appropriateness of service, frequency and amount of visits and supply utilization. Participates in Lean events as assigned or volunteers. Nursing practice reflects available best evidence Participates as a member of quality committee throughout the year.** Participates in committee or task force on unit enhance function of own unit.* (WEIGHTED 2 pts/4 pts max) Participates in LUHS wide or division wide committees or task forces. Brings information back to peers for change in practice. (i.e. practice council, skin care liaison, restraints liaison, Gift of Hope liaison, Preceptor task force etc.)** (WEIGHTED 2 pts/ committee) Participates in developing change plan for unit wide implementation in response to research and quality articles. (WEIGHTED 2 pts) Completes 2 Loyola e-journal CEUs. ***(WEIGHTED 1 pt/2pts max) Collaborates in implementing a nurse, multidisciplinary or MD research study. ****** (WEIGHTED 2 pts) **Verification from committee chairperson and manager using the Committee Participation Letter. Initiates and leads quality improvement projects with stated goals and continued effort to reach desired outcomes. Evaluates and reports outcomes of projects quarterly using CCE format.** (WEIGHTED 5 pts/project) Initiates and leads committee or task force to enhance function of own unit.**** (WEIGHTED 3 pts/6 pts max) Chair or active in accomplishing the work of an LUHS wide committee through subcommittee work or tasks beyond basic expectation of all committee members.** (WEIGHTED 2 pts/max 4 pts for any one system committee) Chairs an LUHS wide nursing council. (WEIGHTED 5 pts) Achieves content expert recognition in Lean. (WEIGHTED 2 pts) Develops an evidence-based standard of practice or revises policy to reflect current evidence.***** (WEIGHTED 4 pts8 pts max) Assists 5 different peers to participate in Loyola e- journal CEUS and includes peers certicates. Creates a critique for a Loyola e-journal article in collaboration with a member of the Research Committee.***** (WEIGHTED 5 pts) Implements a nursing research study. (WEIGHTED 5 pts) ***QI project report forms that clearly state goals & clinical outcomes of project as well as demonstrates your specific involvement. ****Purpose of committee, membership, outcomes achieved or current status of work with verification by unit manager *****Copy of evidence based standard of practice; policy or research critique with verification of implementation. ******Verification of participation from the primary investigator or their representative. 2001 Loyola University Health System Home & Hospice Criteria Page 10 of 13

PROFESSIONAL IDENTITY: PROFESSIONALISM Completes work with a positive work ethic in compliance with employee handbook. Completes all aspects of work; organizes & prioritizes to manage self. Resource for functioning with a positive work ethic in compliance with employee handbook. Performs work consistent with identified Magis behaviors. Responds to patients, families and staff in a non-judgmental way with respect. Shares insights that reflect response of current nursing learning and new perspectives. Provides care in a way that preserves patient s privacy and dignity. Initiates actions to resolve concerns and enhance patient satisfaction Receptive to new ideas incorporating new knowledge, technology and activities into practice. Professionally responds to required relocation to other units for staffing needs. Displays security in knowledge base to support clinical judgement and plan interventions. Maintains therapeutic relationship with appropriate boundaries between nurse, patient and family. Performs work as a role model in utilizing Magis behaviors. Encourages and motivates others to respond to changes and new ideas. Demonstrates flexibility by volunteering to relocate to other units as a professional role model.* (WEIGHTED 1 pt) Belongs to a national professional organization.** (WEIGHTED 1 pt/org/ 3 pts max) Support peers in dealing with patient and family situations to enhance a therapeutic relationship. Publishes article in non-peer reviewed journal or Loyola Newsletter. (WEIGHTED 1 pt/article/max 4 pts) Submits a Loyola Magnet Hero Story on intranet. (WEIGHTED 1 pt) Presents a poster at an external conference. ***** (WEIGHTED 2 pts/event to a maximum of 4 pts) Fosters an environment that encourages positive work ethic as outlined by employee handbook. Provides feedback to colleagues to enhance their function using Magis behaviors. Educates peers on change management theory. Active in a professional organization.*** (WEIGHTED 2 pts/org. max 4 pts) Officer in a professional Organization/s.*** Advises and consults with peers on developing and maintaining appropriate boundaries in complex situations. Writes and submits an article for publication in a peer reviewed journal. (WEIGHTED 3 pts/article) Publishes article in a peer reviewed journal. (WEIGHTED additional 2 pts/ article) Participates in planning and/or coordinating an LUHS or external professional conference or meeting.***** Presents a podium presentation at an external conference. **** * (WEIGHTED 5 pts/event; maximum of 10 pts; 2 additional points for the same presentation at an additional site) *Clinical log entries demonstrating a minimum of 3 volunteer relocations signed by a supervisor or manager. **Current membership card *** Documentation of committee involvement, office held, and/or list of meetings attended. ****Outline of educational event, and copy of policy incorporating changes when appropriate. *****Conference brochure with presentation or abstract noted or copy of abstract presented or role in planning event. 2001 Loyola University Health System Home & Hospice Criteria Page 11 of 13

PROFESSIONAL IDENTITY: COMMUNICATION Identifies limits of communication skills and seeks development opportunities. Communicates clearly and calmly using accurate clinical language. Communicates clearly, calmly, concisely and persistently with entire multi-disciplinary team. Identifies need for interpretive services, aware of systems to access a translator. Follows through on patient/family questions and responds in an acceptable time frame. Elicits patient and family needs and questions prior to ending an encounter. Recognizes areas of uncertainty related to care provider s limits and seeks assistance to accurately identify and respond through higher authority. Participates as a member of a group or team in patient care as well as unit related task forces. Utilizes interpretive services as needed. Answers patient/family questions in a complete, constructive and empathetic manner. Includes family in communication and education as clinically necessary and desired by patient. Accurately identifies situations of care provider s limits and pursues information and/or action from higher authority. Provides answers, teaches patients, students at the appropriate level. Assesses communication needs of complex patient/family situations. Accurately identifies pt care situations of care provider s limits and pursues information and action from higher authority persistently. Shows evidence of following chain of command through administrator on call or attending physician.* (WEIGHTED 1 pt) Functions in a leadership role for a team of care providers and/or a unit related task force. Utilizes negotiation skills to deal with conflict within multidisciplinary team. Completes recognition as medical interpreter through patient relations and documents aminimum of 3 events in the clinical log in one year of being utilized with a patient/family as an interpreter.** (WEIGHTED 5 pts) Models and teaches others how to respond to patient/ family questions, concerns and complaints. Consults with others to develop a plan to meet communication needs of complex patient/family situations. Mentors others to develop the skill of leading a group or team. * Clinical log entries citing three specific events of following the chain of command to seek information or action from someone of higher authority related to care providers limits. ** Include copy of certificate indicating completion of training from the Patient Relations Department. 2001 Loyola University Health System Home & Hospice Criteria Page 12 of 13

APPENDIX CLINICAL LADDER APPLICATION CHECKLIST As a way of reviewing your application, here is a checklist of what must be included: Nursing Clinical Ladder Application including Weighted Criteria Listing available on intranet Clinical Ladder Guidelines Manager Letter available on intranet Clinical Ladder Guidelines Peer review forms minimum of 3, available on intranet Clinical Ladder Guidelines o 360 Forms optional or may be used to supplement peer forms to total 3 available on intranet Resume or work history (unnecessary for renewals) Clinical Ladder Guidelines One paragraph demonstrating your planning and critical thinking skills while dealing with a difficult or challenging patient, organizing a discharge or planning care from an admission. (unnecessary for renewals) Nursing Process. Education record (available on intranet) showing a minimum of 6 education events other than mandatory in-services Knowledge Seeker. CE certificates showing 16 CEs obtained in previous year or report card demonstrating sufficient coursework to be equivalent to 16 CEs (excludes use as weighted criteria) Knowledge Seeker. Clinical Log available on intranet documenting specific events with the specific date of occurrence that demonstrate clinical, leadership and overall performance at the level for which you are applying and specific events that support weighted criteria. There must be specific entries for 8 of the past 12 months. Clinical Ladder Guidelines Documentation of certification that is current for Level 4 applications Knowledge Seeker. Documentation required (see criteria * notes) for specific weighted criteria for which you are applying. (Diploma or transcript if applying for BNS and/or MSN weighted points). 2001 Loyola University Health System Home & Hospice Criteria Page 13 of 13