REPORT OUT TEMPLATE. Please refer to the C.A.R.E bylaws and other program material for additional information.

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Scholar Name: REPORT OUT TEMPLATE Project Title: Goal: 1. Complete the Report Out template 2. Have your Mentor complete: Mentor Showcase Recommendation 3. Using the Report Out template, discuss your project during your campus council (or other designated council) meetings**, NO LATER than September 1 Please refer to the C.A.R.E bylaws and other program material for additional information. ** Depending on which tract of Specialty Scholar, will determine which council meeting you should report. i.e. Quality Scholar will report out to the Quality Council meeting. If you are unsure, discuss with your mentor.

Background: The SO WHAT?! Scope / Population Deliverable Completion Dates: Charter: Process Map: Fishbone: Alignment to Hospital/system goals: Where does your project fit in? Intervention: What are you going to actually do? What was your measure (s): You rolled out your plan What happened? Just describe Did you need to rethink/redo your plan after you implemented? NO PROBLEM! VERY NORMAL! Go to the end of this document and just add another PDCA cycle! Number them 1, 2, 3 etc so you can keep track of all work! What did the data tell you! Did you improve? Why or why not! Check Plan Do Did you reach your goal? Did you improve? What do you do now? Act

Next Steps: Project Focus: Identify trends in Pt Sat. Advance Nursing Research Evaluate nursing practice Translate new knowledge Identify innovations Evaluate Technology/IS to improve practice Other: Magnet Model Component: Trans. Leadership Exemplary Prof. Practice Structural Empowerment New Knowledge, Innovation & Improvements Empirical Outcomes Multidisciplinary Team: Medical Staff: Pharmacy: PT/OT/ST: Case Mgt.: Dietary: Chaplain: Other: Outcome Area: Patient Safety Patient Sat Patient and Family Engagement Nursing Sat Workplace Safety Practice Improvement Use next page for your additional PDCA cycles! You should expect to need AT LEAST 1 additional page!

Do you need to rethink your plan? REPORT OUT TEMPLATE You rolled out your plan What happened? Just describe What did the data tell you! Did you improve? Why or why not! Check Do Plan Did you reach your goal? Did you improve? What do you do now? Act

Below are the requirements to maintain your status. Sharing of information, attending monthly meetings, promoting awareness of the status of your project, etc. Refer to the C.A.R.E manual for explanations. What, if any, assistance do you need from your mentor and/or CARE SS Leader: Barriers & Obstacles: Specialty Scholar meetings attended (or alternate): Interdisciplinary Collaboration examples: Progress Report(s) to Unit: Communication with mentor: Educational Program Attended: (title, date, location) Dissemination of findings or information (list type, title, location, and date): Presentation of findings -internal/external: (list) Submission for publication: (list details) National Certification: (type, new or renewal, exp. date) Consultation assistance/support: (including bedside, committees, P&P s, etc.): IRB Status (Research Scholars ONLY): Quality Scholars: Provide examples of the following activities: Promotion of NDNQI Awareness and /or Literature review updates Geriatric Scholars: Provide examples of the following activities: Informal monitoring of pts. > 65 Identification and development of older adult educational materials, including dissemination of resources Geriatric tools utilized, including teaching moments for colleagues Staff development encouragement (PCA to Geri PCA and RN to ANCC) and partnership with Geriatric PCA Communication (Using SPICES and facilitating between providers and NICHE Council) Assisting staff in NICHE utilization

MENTOR ENDORSEMENT Directions: Mentor completes on behalf of mentee. Mentor will use this form to provide feedback on mentee s participation in the Scholar program and progression of the project. If applicable, the Mentor will submit completed forms to the campus lead. All completed forms will be forwarded to the New Knowledge Congress for the Campus Showcase selection process. Nurse Scholar s Name: Campus Unit Project Title: Did the Scholar s project progress in a timely manner Yes No Is the project complete or nearing completion? Yes No Have all of the project components been completed or near completion? Yes No (charter, process flow, fishbone, etc.) Do you feel the project is a candidate to showcase? Yes No (Does it exemplify the work of a Specialty Scholar?) Please provide any comments you feel are important for the New Knowledge Congress to be aware prior to the selection of projects for the Campus Showcases: Mentor: Mentor Signature: Date:

Transformational Leadership Structural Empowerment REPORT OUT TEMPLATE The Gold Standard for Nursing Excellence THE FIVE MODEL COMPONENTS: And the Forces of Magnetism that they contain Exemplary Professional Practice New Knowledge, Innovations, and Improvements Empirical Quality Outcomes 1. Quality of Nursing Leadership Knowledgeable, strong nurse leaders are committed to strong advocacy and support for nursing. 3. Management Style Managers involve staff at all levels of the organization. The nurse leaders provide continuous communication with staff. Feedback is encouraged and valued. 2. Organizational Structure Nursing departments are decentralized with unit-based decision-making and strong nurse representation in committees throughout the organization. 4. Personnel Policies and Programs Salaries and benefits are competitive. The organization offers creative and flexible staffing. 10. Community and the Healthcare Organization Hospitals maintain a strong community presence that includes a variety of long term outreach programs. 12. Image of Nursing Nurses are seen as essential to the hospital s delivery of patient care by all members of the health care team. 14. Professional Development The organization emphasizes orientation, in-service education, continuing education, formal education and career development. 5. Professional Models of Care Nurses have responsibility, accountability and authority in the provision of patient care 6. Quality of Care: Ethics, Patient Safety and Quality Infrastructure Nurses believe that they are giving high-quality care to their patients and that their organization will settle for nothing less than high-quality care. 7. Quality Improvement Staff nurses participate in the quality improvement process, see it as educational and believe it helps improve patient care within the organization. 8. Consultation and Resources Knowledgeable experts, particularly advanced practice nurses, are available and utilized. 9. Autonomy Nurses are allowed and expected to work autonomously, consistent with professional standards, as members of the multidisciplinary team 11. Nurses as Teachers Nurses are permitted and expected to incorporate teaching in all aspects of practice. 13. Interdisciplinary Relationships Nurses, physicians, pharmacists, therapists and other members of the healthcare disciplines treat each other with mutual respect and have positive relationships 6. Quality of Care: Research and Evidence Based Practice Nurses believe that they are giving high-quality care to their patients and that their organization will settle for nothing less than high-quality care. 7. Quality Improvement Staff nurses participate in the quality improvement process, see it as educational and believe it helps improve patient care within the organization. 6. Quality of Care Nurses believe that they are giving high-quality care to their patients and that their organization will settle for nothing less than high-quality care. Reference: ANCC Magnet Overview, Nursing Excellence. Your Journey. Our Passion., MAGBRO07v2 5M 08/08

Specialty Scholar Roles & Responsibilities Description Specialty Scholars are staff nurses who conduct projects in one of three tracts: research, evidence-based practice (EBP), quality improvement (QI), and/or focus on Gerontology for the purpose of generating new knowledge, implementing best practices, and/or improving current care processes. Specialty scholars work under the guidance of assigned mentors who have expertise in research, EBP and/or QI to produce measurable outcomes that are disseminated to peers and nursing leadership through formal presentations. Specialty scholars may bypass other levels of Clinical Advancement & Recognition of Excellence (Clinical Fellow, Clinical Resource, Clinical Scholar). Eligibility Worked as a nurse for at least two years in a clinical area. Agree to carry out components of the role as delineated in each of the MH model of care areas: Practice, Education, Shared Governance, and Research (see below). Agree to the responsibilities of a Specialty Scholar as delineated below Complete a library session on searching databases Complete the Specialty Scholar Core Curriculum Responsibilities Continually conduct projects, under the guidance of a mentor Lead unit-based teams in completion of project Attend a minimum of 50% of council (or special interest group) meetings per year Report progress of project at staff meetings, unit-based council meetings, and hospital-wide council/committee meetings Maintain timely communication with mentors (including email responses) Disseminate project findings yearly in podium or poster presentation Maintain specialty specific responsibilities, as indicated below Process Submit a completed application as directed (including sign-off by nurse manager) indicating your topic and area of interest. Date, time and location of Core Curriculum are o posted in the online education book o disseminated to all staff nurses via e-shift o posted on the RN CARE Webpage The receipt of the application serves as registration for the Core curriculum Candidates are guided by mentors to the appropriate tract (research, EBP, QI, Geriatrics) during the Core Curriculum Upon completion of the Core Curriculum, applications are forwarded to the CARE committee for final approval

Specialty Specific Responsibilities REPORT OUT TEMPLATE Quality Improvement Acts as a role model for other staff by championing nursing quality improvement initiatives, leading Plan/Do/Check/Act (PDCA) quality teams and being a conduit of information on quality care processes and information. Clinical Practice Identifies clinical area for improvement (eg. pressure ulcers, falls, pain management, HCAHP scores) Leads unit-based team to meet or exceed quality standards using PDCA tools Education Disseminates information about nursing quality through, for example, unit in-services, journal articles, and dissemination of quality reports Attends one nursing quality related educational program per year (beyond quality core) to enhance selfknowledge. Shared Governance Promotes collaboration with interdisciplinary team on nursing quality initiatives Engages other CARE program nurses (clinical scholars, resources, and fellows) as team members Promotes awareness of National Database of Nursing Quality Indicators (NDNQI) results Research Conducts literature review to assure current standards reflect the best available evidence Evidence Based Practice Possesses an inquisitive spirit and a desire to improve nursing care by conducting, implementing, translating and evaluating evidence-based reviews at Meridian Health. Clinical Practice Promotes evidence-based practice on unit Identifies clinical questions suitable for investigation Demonstrates expert critical thinking Education Disseminates evidence findings to other staff on unit through in-services, posters, journal clubs, etc. Presents own evidence findings in defined formal forums within Meridian Health. Seeks opportunities to present evidence findings at local, state or national conferences or through publication in peer reviewed journals. Attends one evidenced base related education program per year Shared Governance Promotes collaboration with interdisciplinary team on evidence projects Active member of EBN Special Interest Council attending at least 50% of meetings. Research Disseminates current evidence findings to staff and members of the interdisciplinary team.

Research Possesses an inquisitive spirit and a desire to improve nursing care by designing and conducting original clinical nursing research studies at Meridian Health. Clinical Practice Promotes evidence-based practice on unit Identifies clinical questions suitable for research investigation Demonstrates expert critical thinking Education Disseminates research findings to other staff on unit through in-services, posters, journal clubs, publication in INSPIRE, and/or evidence-based practice reviews. Seeks opportunities to present research findings at local, state or national conferences or through publication in peer reviewed journals. Attends one research-related education program per year (beyond the core curriculum) to enhance self-knowledge (e.g. Nursing Research & EBP Day, JSUMC Research Day, local Sigma Theta Tau International Research Day). Shared Governance Promotes collaboration with interdisciplinary team on research projects Research Designs, implements, evaluates and disseminates research according the CRS role guidelines. Specialty Focus: Geriatrics Possesses a positive attitude with demonstrated interest in providing excellence in geriatric care. Acts as a role model for other staff by championing geriatric best care practices and protocols, while assisting colleagues and other healthcare workers with geriatric competencies, with an emphasis on improving care and outcomes for the older adult in our healthcare system via Quality Improvement, Evidence Based Practice and/or Research.. Specialty Scholars in Geriatrics must become Gerontological Nurse certified within a year Clinical Practice Conducts informal monitoring of older adult patients > 65 years of age. Delegates to and partners with Geriatric PCA to improve bedside care of the older adult patient Assists staff in utilizing NICHE (Nurses Improving Care for Healthsystem Elders) protocols Communicates using SPICES format to facilitate older adult issues during reports with staff members and rounds with the interdisciplinary team. Demonstrates understanding and use of geriatric assessment tools and teaches other nurses to use them. Education Disseminates information about older adult care management through a variety of mechanisms including coordination of unit in-services, journal article reviews, and dissemination of NICHE protocols. Identifies the need for and assists in the development of older adult patient education materials. Provides geriatric consultation/support at the bedside and throughout the hospital Encourages PCAs to attend Geriatric PCA training program Encourages Nurses to become certified in their area of practice

Attends one care of the older adult educational program per year to enhance self-knowledge. Shared Governance Promotes collaboration with interdisciplinary team on care of the older adult best practices Active Member of NICHE Council. Facilitates communication between care providers and NICHE Council members. Promotes awareness of community resources for the older adult patient. Participates on unit or hospital wide committees to represent older adult interests and updating policies and procedures related to best care practices Research Promotes an environment of Evidence Based Practice (EBP) as related to the older adult patient Conducts Research, EBP, or Performance Improvement activities related to care of the older adult Disseminates current research findings to staff and members of the interdisciplinary team.