What Does it Really Mean to be Educated and Competent?

What Does it Really Mean to be Educated and Competent? Erin M. Conahan, MSN, RN, ACNS-BC, CNRN, SCRN Dena R. Brown, MSN, RN, CMSRN Disclosure The authors have no actual or potential conflict of interest in relation to this presentation. 1

Objective Discuss two innovative educational practices and how on-going education can improve staff satisfaction and turnover. Educated vs Competent Educated Having an education; having an education beyond the average Giving evidence of training or practice; befitting one that is educated; based on some knowledge of fact Competent Proper or rightly pertinent Having requisite or adequate ability or qualities Legally qualified or adequate, a competent witness Having the capacity to function or develop in a particular way Having the capacity to respond (as by producing an antibody) to an antigenic determinant, immunologically competent cells Retrieved from https://www.merriam-webster.com/ on 3/6/17. 2

Continuing Nursing Education Professional Licensure requirements by state Certification requirements Career advancement/enhancement Institutional Magnet facilities Unit/population/role specific Regulatory http://www.inscol.com/healthskills/wp-content/uploads/2015/05/importance-of-continuingeducation-in-nursing.jpg 50 shades of grey? clinical staff has the knowledge of demonstrate knowledge of demonstrate competency demonstrate utilization assess practitioner competence on an on-going basis Members of the core stroke team receive at least 8 hours annually of continuing ED staff, as identified by the organization, participates in educational activities related to stroke diagnosis and treatment a minimum of twice per year The Joint Commission (2017). Disease specific certification manual. 3

Educated When? School, experience Orientation to hospital Orientation to unit Annual education Just-in-time education How? Instructor led classes Webinars On-line industry sponsored education Sponsored by national organizations Conferences/lectures Journal articles/journal club E-learning/LMS Traditionalists (Silent Generation) Born 1922-1945 Strong respect for authority Disciplined/adhere to rules Loyalty to their organizations Expect respect The Generations Baby Boomers Born 1946-1964 Feel they have sacrificed to reach their position Optimistic Highly competitive/over achievers Team players Prefer a personal style of communication 4

Generation X Born 1965-1980 Prefer fun and not workaholic lifestyles Most are not team players Prefer to focus on outcomes and not processes Loyal to their career goals; not necessarily the organizations Work-life balance very important Latch key children The Generations Millennials (Generation Y) Born 1981-2000 Heavily programed as youths by atschool & after-school activities Highly collaborative & optimistic Technology-dependent They are use to influencing decisions Multitasking is technology-dependent Work-life balance very important Desire personal attention Generational Learning Styles Traditionalists: traditional classroom, well-defined goals and objectives summarized in handouts Baby boomers: want to understand how information will be valid and useful in their lives; partners in learning process Generation X: distance learning, hands-on activities, role playing, visual methods Generation Y: learning is expected to be fun with immediate feedback; blended learning and group interaction, use of technology 5

So what can each generation offer the nursing teams, their colleagues, their patients?? Each generation is shaped by the time in which they grew up, including their family culture, parental influences, and technology it s important to have a level of understanding of each generations values Understanding the differences in generations allows for successful communication, and most importantly less offensive communication (offensive being in the eye of the beholder) Education of each generation must be handled the same way with understanding of the culture in which each generation were raised An example includes Baby Boomer s lack of knowledge of electronics although it is impossible to avoid the digital age, care and patience must be used when educating allowing Generation Y (Millennial) to mentor the Baby Boomers will be helpful, as well as team-building Conversely, Baby Boomers clinical expertise is greatly needed to educate and mentor younger, less experienced nurses Educators must understand and be considerate of generational differences and approach education to meet the needs and expectations of various age groups Adapt and alter education to meet the needs of the group (this may not be realized at first and may have to be on the spot ) For example: be willing to offer education online, as well as on paper/posters 6

Active education Mock stroke drills Case presentations Poster/podium presentations Hands-on testing Participation in research Teach http://www.barnesjewish.org/portals/0/images/medical%20services/neuro logy%20&%20neurosurgery/stroke%20center/treatment%20for%20stroke %20Patients/treatment-stroke-patients.png Fairview Simulation Code Brain Attack ED Unannounced Stroke Simulation from ED triage through IR Biplane took place April & August 2016 Volunteers played the patient and the patient s sister Teamed up with Nichole Kelsey from Cleveland Clinic s Main Campus s Simulation Center her team made a life-like arm which had a vein where blood could be drawn Nursing Informatics helped with making sure we were able to place the test patient in EPIC (so patient had nursing notes and orders) 7

Stroke Simulation Goals Evaluate performance of multidisciplinary team Time Elements Evaluate team performance with new biplane capabilities (opened Feb 2016) Simulation patient prep Brain Attack CT 8

Telestroke evaluation Mixing of alteplase(iv tpa) Hyperacute MRI Debrief 9

2016 Stroke Boot Camps Fairview s Primary Stroke Center Program held two Stroke Boot Camps for nursing -4 hour boot camps had a multidisciplinary approach to cover the continuum of stroke care 3.5 CMEs offered to each participant What innovative education methods are you using? 10

Competence ANA Position statement: The public has a right to expect registered nurses to demonstrate professional competence throughout their careers. ANA believes the registered nurse is individually responsible and accountable for maintaining professional competence. The ANA further believes that it is the nursing profession s responsibility to shape and guide any process for assuring nurse competence. Regulatory agencies define minimal standards for regulation of practice to protect the public. The employer is responsible and accountable to provide an environment conducive to competent practice. Assurance of competence is the shared responsibility of the profession, individual nurses, professional organizations, credentialing and certification entities, regulatory agencies, employers, and other key stakeholders. http://www.nursingworld.org/mainmenucategories/thepracticeofprofessionalnursing/nursingstandards /Professional-Role-Competence.html Retrieved on 3/8/17 Joint Commission CSC Guidelines The program assesses practitioner competence on an ongoing basis. This assessment is documented. RNs that staff the dedicated neuro-intensive care beds for complex stroke patients demonstrate expertise in the following: Neurologic and cardiovascular assessment Nursing assessment and management of ventriculostomydevices (external ventricular pressure monitoring and drainage) Treatment of intracranial pressure Nursing care of hemorrhagic stroke patients (intracerebral hemorrhage and subarachnoid hemorrhage) Nursing care of patients receiving intravenous thrombolytic therapy and intra-arterial thrombolytic therapy Management of malignant ischemic stroke with craniectomy Use of thermoregulation protocols Use of intravenous vasopressor, antihypertensive, and positive inotropic agents Methods for systemic and intracranial hemodynamic monitoring Methods for invasive and noninvasive ventilatory management The Joint Commission. (2016). Advanced Disease-Specific Care Certification Requirements for Comprehensive Stroke Center (CSC). 11

Competency levels ongoing assessment Level I: What an individual knows measured by his or her general knowledge Level II: An individual knows how to act measured by his or her competence Level III: An individual shows how to act as measured by his or her performance Level IV: What an individual does as measured by his or her action Competence Skills assessment on hire Procedural vs nonprocedural; psychomotor vs clinical reasoning Annual education High risk, low volume Problem prone procedures or situations Unusual incidents or regulatory requirements with a connection to quality improvement efforts New equipment, new procedures, changes in regulation, changes in evidence Assessment comparison 12

How are you measuring competence? How does competency evaluation lead to retention? Ensure staff has the skills and abilities they need to perform to the expectations of their job description and organizational policies and procedures. Determine gaps in employee performance that need to be closed to ensure safe and competent care. Evaluate job performance. ($$$) Provide aggregate data on competency patterns and trends as a basis for staff education and practice changes. Use competency data in organizational quality improvement efforts. Match staff according to patient needs (Synergy model) Ensure standardization, safety, and quality 13

References Bell, J.A. (2013). Five generations in the nursing workforce. Journal for Nurses in Professional Development, July/August: 205-210. Blevins, S. (2014). Understanding learning styles. MedSurgNursing, 23(1): 59-60. Coulter, J.S. & Faulkner, D.C. (2014). The multigenerational workforce. Professional Case Management, 19(1): 46-50. Dols, J., Landrum, P., & Wieck, L.K. (2010). Leading and managing intergenerational workforce. Creative Nursing, 16(2): 68-74. The Joint Commission. (2017). Advanced disease-specific care certification requirements for primary stroke center (PSC). The Joint Commission. (2016). Advanced disease-specific care certification requirements for comprehensive stroke center (CSC). Kaplow, R. and Reed, K.D. (2008). The AACN Synergy model for patient care: a nursing model as a force of magnetism. Nursing Economics, 26(1): 17-25. Levine, J and Johnson, J. (2014). An organizational competency validation strategy for registered nurses. Journal for Nurses in Professional Development, 30(2): 58-65. DOI: 10.1097/NND.0000000000000041 Lipscomb, V. (2010). Intergenerational issues in nursing: Learning from each generation. Clinical Journal of Oncology Nursing, 55(3): 267-269 14