UNIVERSITY MEDICAL CENTER NURSING ADMINISTRATION POLICY AND/OR PROCEDURE UMC RN CAREER LADDER. Executive Vice President / Chief Nursing Officer

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UNIVERSITY MEDICAL CENTER NURSING ADMINISTRATION POLICY AND/OR PROCEDURE NA-124.0 TITLE: UMC RN CAREER LADDER Sponsoring Committee / Department Nursing Administration Committee Approval Required: Key Words: RN, Developing Skills, Requirements, Criteria, Incentive Cross References: Date Instated: 08/01/2006 Effective Date 08/08/2018 APPROVED BY: Tammy Williams, DNP, RN Executive Vice President / Chief Nursing Officer Revised items are in black bolded font Current revision by Tammy Williams, DNP, RN STATEMENT OF PURPOSE: The University Medical Center RN Career Ladder for Registered Nurses (RN) is a voluntary program that recognizes and rewards RN s for developing their professional practice skills and contributing to improved patient care. The ladder has been designed to engage nursing in the support of the UMC mission. TEXT: SPECIAL NOTE: RN employees are eligible for the career ladder after 1 year of continuous service at UMC. Minimum of 12 months between application processes to advance the ladder If criteria point is part of normal job description, it will not be accepted for career ladder. Criteria components must be accomplished within the past 12 months with supportive documentation of current validation. Nurse Directors & Assistant Nurse Directors & Educators - Items asterisked (**) must be done in a department other than your own. Employees must submit an application and portfolio annually with current information to stay on the Career Ladder. Each item can only be used once for criteria components. Employees are not eligible for Career Ladder if they have given termination notice. If notice is given prior to receiving the Career Ladder check, the check will be held. Work with students is excluded, as it is the mission of UMC. Goal: Enhance the art and science of nursing practice and promote high quality care and to advance professional practice. Objectives: Page 1 of 7

1. Provide opportunity for advancement in the practice setting 2. Recognize highly qualified nurses 3. Utilize experienced nurses to be the catalyst that initiates, drives and sustains a multidisciplinary approach for achieving a delivery model that is efficient, customer focused and cost effective. 4. Develop strategies that facilitate evidence based nursing practice. 5. Promote and enculturate the UMC Professional Practice Model. The RN Career Ladder consists of 5 levels. In order for the registered nurse to advance through the career ladder he/she must meet and submit evidence that they have met the requirements for each level. The five levels are: RN I RN I RN II RN III RN IV RN V Diploma, ADN, BSN, MSN, or DNP/PhD in Nursing Minimum of 1 year RN working experience Required to meet and provide supportive documentation of accomplishment of three Full Time - Lump sum bonus of $500.00 after approval by RN Career Ladder Committee Part Time Lump sum bonus of $250.00 after approval by RN Career Ladder Committee On-Call Lump sum bonus of $250.00 after approval by RN Career Ladder Committee RN II Diploma, ADN, BSN, MSN, or DNP/PhD in Nursing Minimum of 2 year licensed nurse experience Page 2 of 7

Interview with RN Career Ladder Review Board if required Required to meet and provide supportive documentation of accomplishment of six Full Time - Lump sum bonus of $1,000.00 after approval by RN Career Ladder Committee Part Time Lump sum bonus of $500.00 after approval by RN Career Ladder Committee On-Call Lump sum bonus of $500.00 after approval by RN Career Ladder Committee RN III Diploma, ADN, BSN, MSN, or DNP/PhD in Nursing Certification required Minimum of 3 year licensed nurse experience Resume or Curriculum Vitae Required to meet and provide supportive documentation of accomplishment of nine Full Time - Lump sum bonus of $2,000.00 after approval by RN Career Ladder Committee Part Time Lump sum bonus of $1,000.00 after approval by RN Career Ladder Committee On-Call Lump sum bonus of $1,000.00 after approval by RN Career Ladder Committee RN IV BSN, MSN or DNP/PhD in Nursing required Certification required Minimum of 4 years licensed nurse experience Resume or Curriculum Vitae Page 3 of 7

Interview with RN Career Ladder Review Board Required to meet and provide supportive documentation of accomplishment of twelve Full Time - Lump sum bonus of $4,000.00 after approval by RN Career Ladder Committee Part Time Lump sum bonus of $2,000.00 after approval by RN Career Ladder Committee On-Call Lump sum bonus of $2,000.00 after approval by RN Career Ladder Committee RN V Licensed as a RN in the state of Texas (Compact recognized) for minimum of 12 months MSN or DNP/PhD in Nursing required Certification required Minimum of 5 years licensed nurse experience Resume or Curriculum Vitae Interview with RN Career Ladder Review Board Required to meet and provide supportive documentation of accomplishment of fifteen components from the criteria Must submit 1 of the following criteria components: (last 5 components 28, 29, 30, 31, or 32) Full Time - Lump sum bonus of $6,000.00 after approval by RN Career Ladder Committee Part Time Lump sum bonus of $3,000.00 after approval by RN Career Ladder Committee On-Call Lump sum bonus of $3,000.00 after approval by RN Career Ladder Committee Criteria: 1. Active participation in external community health affiliated project a total of 20 hours must be documented BE SPECIFIC individual hours must be listed per date on Participation Guide - (Medical Relief, Children s Health, Cancer, Heart Health, Safety, Diabetes, Nutrition, etc.(2 hours maximum for walking)). Food Sale/Fundraising (maximum 2 hours/day (cooking, sales only)) 2. Active participation in a UMC project a total of 20 hours must be documented BE SPECIFIC individual hours must be listed per date on Participation Guide - (Children s Miracle Network, Spirit Team, Thirty Minute Club, Administer Employee TB tests ((maximum of 2 within the department and/or additional hours documented by Employee Health for house-wide event on participation guide, and Director signature required)), TB Fit Mask Team ((maximum of 2 hours and Director signature required)), Employee flu shot Page 4 of 7

administer ((maximum of 2 hours and Director signature required)), UMC approved translator ((must attach translator form document hours on Participation Guide with Charge Nurse signature and maximum of 2 hours per day), NODA ((NODA committee signature per event)), Peer interview ((maximum 30 minutes per interview list separately - and Director signature required)), Super Users ((signature required from Nursing Education per event)), etc ), free wellness patient screenings (must be signed off by Director and maximum of 2 hours), (TB, flu must be signed off by director), Proctor for Level 5 Leadership, Unit-based reward and recognition activities ((document specific hours and Director signature required)), NDNQI Prevalence Study, Round with Lean Daily Management (LDM) Admin. Team, Grievance hearing outside your department (Signature required by HR Director), Educators assisting with audits outside their department. Food Sale/Fundraising (maximum 2 hours/day (cooking, sales only)) *No committee meetings. *Monetary donations excluded. 3. Professional national certification (must provide copy of current card). 4. Membership in a recognized professional nursing organization for minimum of 6 months (must provide current card) with previous 6 months membership proof. 5. **Assist in educational activity that enhances nursing practice that is recognized and signoff on participation guide by the Nursing Education Department or Clinical Instructor. Minimum of 4 hours. BE SPECIFIC (teach internship classes, teach charge nurse class, teach mentor class, teach portion of annual competency or at competency fair, Super User who teaches classes, etc.) 6. Instructor of a specialty training program (ACLS, BLS, PALS, TNCC, NRP, L5L, etc ). Required to teach 2 classes per 12 month period, documentation required and copy of Instructor Card or Certificate required. 7. Serves as unit preceptor (employees only) 48 hours documented in past 12 months. Proof from Lawson or KRONOS with date report is printed and documentation of preceptor class (certificate or education record) during employment at UMC. 8. Serves as an active mentor (must submit month 1 and month 6 for regular mentees or month 1 and month 3 for transition mentees). Completion date of mentoring must be during the previous 12 months. No more than two monthly agendas may be submitted to Nursing Recruitment within the same month. All mentoring assignments (unless approved by Nursing Recruitment) must be completed by the mentees 7 th month of employment (driven by nursing orientation dates) or the 4 th month of employment for the transition mentee. The Transition Mentee is a UMC employee who has worked at UMC as Nurse Tech prior to becoming a Graduate Nurse. Credit will not be given for this component in the event the Mentor does not complete the mentoring period within a 7-month timeframe or a 4-month timeframe in the transition program. Completion dates must be validated by the Nursing Recruitment Department as evidenced by a signature on the participation guide. 9. **Serves as Charge Nurse, 48 hours documented in past 12 months. Proof from Lawson or KRONOS with date report is printed. 10. Member of specialty procedure team in care of a patient, proof on ICPF with documentation of 2 verifications on back of ICPF (PICC, neonatal transport, CRRT, ECMO, etc..). 11. Serves as an active rapid response team member and must show attendance at 4 monthly RRT meetings per year (minutes required with name present) and show documentation of 6 rapid response assessments. (not applicable to RRT Cost Center employees) 12. Serves as an active member of Alcohol Intervention Team. Must show attendance at 2 quarterly meetings per year (minutes required with name present or documented on education record) and show documentation of 4 interventions in past 12 months. Page 5 of 7

13. **Serves on an active unit-based or hospital-based committee related to professional growth, patient care or performance improvement. (Examples of committees/activities that are excluded: Decorating committees, departmental party planning, unit-based employee recognition, NDNQI Prevalence Study). If there are questions about a committee, please contact a committee member. (Must provide documentation on individual education record or minutes with documentation of attendance at 4 meetings per year, regardless of meeting schedule. Credit given for only 1 committee) 14. Chair / co-chair of hospital-based (not unit based) committee. (Must not be same committee as #13 or #15. Must provide documentation on individual education record or minutes of attendance at 4 meetings per year, regardless of meeting schedule. Credit given for only 1 committee) 15. Chair, Co-Chair, Secretary of Unit-based Council must provide documentation on individual education records of attendance at 10 meetings per year and active participation in 4 meetings per year. Must provide documentation of attendance on education record and must provide Unit-based Council meeting minutes reflecting presenter of discussion item or documentation of completion of minutes (approved Unit-based Council minute template only). 16. Develop CNE program as Nurse Planner, Presenter, or Planning Committee Member. Activity must be offered at least once. Provide a copy of the completed roster. Include Participation Guide with signature from Nursing Education. 17. **Serves as an individual project leader (approved by Director or Sr. VP in advance) to develop a NEW program, process, system, database used to measure patient outcomes or simulation scenario (approved by Nursing Education) with simulation scenario application included as proof. 18. Identify and prepare grant funding proposal for committee review (proof of individual participation). 19. **Conducts return on investment in nursing practice and identify savings in clinical practice. Supporting evidence must include but not limited to a.) Documentation of individual work; b.) Completed Project Guideline form; c.) Documentation of return of investment. 20. **Identify and initiates process changes that minimizes human error factor and promotes patient safety (approved by Director or Sr. VP), documentation required to include all of the following: a.) Dated copy of current process or policy, b.) New process or policy with date, and c.) Proof of staff meeting minutes reflecting education of the practice change. Proof of individual work required. OR Identification and implementation of a national nursing practice or nursing practice environment change as evidenced by all of the following: a.) Dated copy of the guideline change, practice alert, or scope of practice change related to nursing practice or nursing practice environment, b.) A nursing policy change (unit based or organizational) related to nursing practice or nursing practice environment, and c.) Proof of staff meeting minutes reflecting education of the change. Proof of individual work required. 21. **Develop and implementation of Evidence Based Practice/Quality Improvement project as approved by signature from Director or Sr. VP. Project Guideline form must be completed and submitted. Proof of individual work must be provided. 22. Holds a BSN, MSN, MBA, DNP, PhD, or MHA (these are the only degrees accepted and you must provide diploma or transcript) 23. Active attendance (90%) and participation in the Nursing Community Research/Best Practice Academy as evidenced by proof of attendance and Evidence Based Practice/Quality Improvement/Nursing Research poster enrolled in the annual Prosperity Bank Nursing Poster competition. Page 6 of 7

24. Demonstrates primary initiative with design and implementation of technology (software, hardware, equipment, apps, etc ) to enhance the patient experience and/or nursing practice. Supporting evidence must include a.) documentation of communication (meeting minutes, email, etc.) to Nursing Director, Sr. VP of Nursing, or Nursing IT, b.) completed Project Guideline form, and c.) completed data documentation. 25. Present individual professional healthcare related speaking presentation as evidenced by written summary, with objectives and at least 2 references, or Power Point with objectives and at least 2 references. Completed roster with 50% of departmental employees signatures required or 100% in departments with 15 employees or less. 26. **Presents individual professional health related poster as evidenced by written original work, with objectives and at least 2 references. Poster presentation to department to enhance nursing knowledge as evidence by completed Poster Guideline Form and picture of poster and completed roster with 50% of departmental employees signatures or 100% in departments with 15 employees or less. Tri-fold or laminate poster required. 27. Participates in formal healthcare related speaking presentation with at least 2 references of 30 minutes or more outside your department as evidence by written summary of project with objectives, or PowerPoint with objectives. Individual work must be identified. Individual department presentation requires 50% of departmental employees signatures or 100% in departments with 15 employees or less. Event roster or badge scanner report required for house-wide presentations (minimum of 15 employees required). Presentations external to UMC require program agenda and signature roster. 28. Poster accepted at annual Prosperity Bank Nursing Poster competition. Must meet requirements of Nursing Research Committee. Copy of poster template and copy of abstract required. Complete poster guideline. 29. Poster presented at national conference for healthcare professionals. Poster must be professionally printed and laminated. Abstract and copy of poster template required. Individual work must be identified. Complete poster guideline form. Proof of conference acceptance/participation required (conference agenda, acceptance letter, thank you letter, email correspondence, etc.) 30. Speaker at regional or national conference for healthcare professionals. Abstract and Power Point is required. Individual work must be identified. Proof of conference speaker acceptance/participation is required (conference agenda, acceptance letter, thank you correspondence). 31. Published article/abstract in peer reviewed journal. 32. Demonstrates and provides an example with supporting evidence of an improvement that resulted from an innovation (cost, efficiency, or care) in nursing practice or the nurse practice environment. Supporting evidence must include a.) documentation of communication (meeting minutes, email, etc.) Nursing Director, Sr. VP of Nursing, or Nursing IT, b.) Completed Project Guideline form, and c.) Completed data documentation. Page 7 of 7