Outstanding Young Nurse Alumnus Award 2014

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HOBY Outstanding Young Alumni Award Nomination Form

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Outstanding Young Nurse Alumnus Award 2014 TO THE NOMINATOR: This nomination packet may be used to nominate a USC Nursing graduate with 10 years or less in the nursing profession and that the nominator believes exemplifies contributions to the nursing profession as outlined in the criteria below. Please follow all of the instructions. The nominator may mail or email all of the information to the College of Nursing at the address found at the end of this form. Please include all additional materials required and submit the completed packet prior to the deadline. Incomplete applications will not be considered. Applications must be received at the College of Nursing by May 20, 2014. Criteria for Selection of Award Recipient The qualified Nominee is an alumnus of University of South Carolina-Columbia, USC Lancaster or USC Salkehatchie campuses College of Nursing s academic program(s). The alumnus may be nominated if he/she: 1. Significantly or uniquely contributes to the nursing profession through (30 points): (a) clinical practice (b) education and teaching (c) administrative organizational leadership (d) research contributions (e) writing and publishing (F) healthcare system changes and/or innovations 2. Demonstrates leadership in (24 points): (a) professional nursing organizations (b) community affairs (c) mentoring/precepting to assist in the development of others 3. Positively promotes and advances the nursing profession in (16 points): (a) practice settings (b) community (c) outreach efforts through volunteerism (d) exemplary personal integrity and character 4. Recognizes and can define his or her own contribution to the overall practice of nursing as described in Criteria 1 (20 points) 5. Articulates how the USC College of Nursing education has benefitted/impacted his or her own personal and professional career (10 points).

Nominee Name: Home Address: City: State: ZIP: Preferred Phone: Secondary Phone: Email: Professional Credentials: Current Position / Title: Business Address: City: State: ZIP: Please submit nominations by May 20, 2014

THE NOMINATOR MUST SUBMIT: 1) Nominator s answers to the three (3) criteria for selection (1 3) (MS Word, up to 2 pages total, standard margins, font size 10 pt.) 2) Nominee s answers to two (2) criteria for selection (4 5) (MS Word, one page total, standard margins, font size 10 pt.) 3) Nominee s most recent Curriculum Vitae (CV) 4) Up to three (3) letters of recommendation/support. (MS Word, one page per recommendation, standard margins, font size 10 pt.) BLIND REVIEW PROCESS: Please note that each nominee will be reviewed by the Selection Committee in a blind review process. Please omit the nominee s name in answers to each criteria selection and in the Nominee's answer to each criteria selection. The name of the nominee will be masked from the CV. NOMINATED BY: Name: Address: City: State: ZIP: Primary Phone: Secondary Phone: Email: How long have you known the nominee and in what capacity? Please mail the nomination packet to: Outstanding Young Nurse Alumnus Award 2014 Selection Committee College of Nursing University of South Carolina Columbia, SC 29208 If you have any questions concerning this application, please call Diane Scott at (803) 777-3468, or email Scottdh@mailbox.sc.edu.

Outstanding Young Nurse Alumnus Award History of the Outstanding Nurse Alumnus Award: The USC College of Nursing, in collaboration with USC Alumni Association and the Alpha Xi Chapter of Sigma Theta Tau International, established the Outstanding USC Young Nurse Alumnus Award in 2011 to recognize nursing graduates with 10 or less years of experience. Each year, the new award winner is recognized and presented a plaque during the Viana McCown Alumni Reunion in the Fall. Information on Selection Process A Blind Review Process is used to evaluate Nominees for the annual Outstanding Young Nurse Alumni Award. All identifying information is removed from each individual nominee s information/materials prior to distribution to the multiple reviewers on the Selection Committee. The committee will rate each nomination following the specific selection criteria outlined on the first page of the nomination form and point values are assigned to determine whether the candidate meets, exceeds, or substantially exceeds each criterion. The rating will determine the award recipient. The Selection Committee is composed of the following representatives:, or designee u, and/or Tips for Completing a Successful Nomination A. Closely follow Criteria for Selection of Award Recipient (page one) of the nomination form to best address the nominee s qualifications and attributes. Specific examples/citations that support the nominee s contributions to nursing and that distinguish her/him as an outstanding young alumnus of the University of South Carolina College of Nursing are encouraged and essential to the unbiased selection process. (See attached examples) B. Omit the nominee s name in answers to criteria for selection (1-3) and in the nominee s answers to criteria for selection (4-5) C. Check List Criteria for Selection defined in the Criteria for Selection as possible.

Please give specific examples that support the nominee s contributions to nursing and that distinguish her/him as an outstanding young alumnus of the University of South Carolina College of Nursing. Refer to the Criteria for Selection of Award Recipients and to Tips for Completing a Successful Nomination. Brief samples of specific answers to Criteria Questions for nominee: 1) Describe significant or unique contributions the nominee has made to the nursing profession. Example: The Nominee has been recognized by the hospital system where she is employed as employee of the year for her nursing unit. She has served as her unit s representative on the hospital shared governance committee. She has implemented evidence-based initiatives as the Skin Champion/ Pressure Ulcer Prevention Team Leader on her unit. As a Magellan Scholar, she has contributed to the advancement of nursing science by conducting research that evaluates interventions to promote mammography screening among women. As an Assistant Nurse Manager in her facility, the nominee promoted contributions of nurses by serving on hospital wide Catheter Associated Urinary Tract Infection Review Committee and chair of the Bloodstream Infection Review Committee. 2) Describe the nominee s leadership in community affairs, nursing professional organizations, and/or assistance to others in the growth and development of these areas (mentoring/precepting). Example: The Nominee has been involved in the following community activities: Troop Leader for the Boy Scouts of America; Secretary for the Family Shelter; Director for the Food Bank Distribution for Food Pantry; Lead Coordinator for Deaconess for a local church; member of the Student Nurses Association. The nominee has served as a Clinical Nurse Specialist for a Medical/Surgical unit. Nominee has been highly involved in mentoring various nursing and respiratory therapy students in the critical care areas. She has served as a Clinical Instructor for two nursing students completing a Dedicated Education Unit for the USC College of Nursing. One example of her support of the community is her development of a mentoring program for teenagers in the Brooklyn School System. 3) Describe how the nominee positively promotes and advances the nursing profession in the community through volunteerism and/or outreach efforts. EXAMPLE: The nominee is currently certified in Advanced Life Support and provides monthly certification and recertification classes in Basic Life Support for staff at a local Nursing Home. She volunteers as part of the Congregational Health Committee in her church and specifically coordinates the fall flu injection schedule and the bi-yearly Health Screening Fair. She serves as a member of the annual planning committee for the city-wide 5K run/walk for Breast Cancer and is the chair of the Health Promotion Committee for a local school PTA. She was a member of a 2010 relief medical team that spent a week in Haiti.