Meridian Health System CARE: Clinical Advancement and Recognition of Excellence Program READ THE DIRECTIONS Save this application to your computer Complete the saved application Directions for Portfolio Development: CLINICAL RESOURCE 1. Read the directions and examples for each section, Clinical Practice, Education, Shared Governance and Research. 2. Complete the fill in forms for: Cover page Manager Endorsement Clinical Practice Self Education Peer Education Patient/Family/Community Education Shared Governance Research 3. Attach your Resume or Curriculum Vitae 4. Each section must be completed and verified. 5. Do not submit copies of articles, packs of education materials, copies of meeting minutes, school papers, etc. 6. Print the completed application beginning with the Cover Page. 7. Submit your completed portfolio in an Interoffice Envelope. Do not use 3 ring binders, sheet protectors or submit original documents. *Your portfolio will not be returned. BCH 2 ND t floor Nursing Supervisor Office JSUMC Mehandru 2 Nursing Office OMC Same Day Surgery RMC Nursing Administration 2 nd Floor SOMC Nursing Resource Office * Please show your unit rep/educator before submission. Incomplete applications will be returned. 2016 1
What Are Your Credentials? What Is the Preferred Order of Credentials? The preferred order is: Highest earned degree Licensure State designations or requirements National certifications Awards and honors Why Is This Order Recommended? The education degree comes first because it is a permanent credential, meaning it cannot be taken away except under extreme circumstances. The next two credentials (licensure and state designations/requirements) are required for you to practice. National certification is sometimes voluntary, and awards, honors, and other recognitions are always voluntary. What Are Examples of Credentials? Educational degrees include doctoral degrees (PhD, DrPH, DNS, EdD, DNP), master s degrees (MSN, MS, MA), bachelor s degrees (BS, BSN, BA), and associate degrees (AD, ADN). Licensure credentials include RN and LPN. State designations or requirements recognize authority to practice at a more advanced level in that state and include APRN (Advanced Practice Registered Nurse), NP (Nurse Practitioner), and CNS (Clinical Nurse Specialist). National certification, which is awarded through accredited certifying bodies such as the American Nurses Credentialing Center (ANCC), includes RNBC (Registered Nurse-Board Certified) and FNP-BC (Family Nurse Practitioner-Board Certified). Awards and honors recognize outstanding achievements in nursing such as FAAN (Fellow of the American Academy of Nursing). Reference: ANCC:American Nurses Credentialing Center. How to Display Your Credentials. ANCC, 2011. 2016 2
MAGNET RECOGNITION PROGRAM The Gold Standard for Nursing Excellence THE FIVE MODEL COMPONENTS And the Forces of Magnetism that they contain Transformational Leadership Structural Empowerment 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. 2016 3
Exemplary Professional Practice New Knowledge, Innovations, and Improvements Empirical Quality Outcomes 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 highquality care to their patients and that their organization will settle for nothing less than highquality 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 2016 4
Clinical Practice Questions -Template pg. 13 Discuss the following as they relate to your clinical practice. Provide specific examples whenever possible. 1. Discuss specific patient care situations where, because of your acquired knowledge base, you anticipated a likely course of events and implemented nursing actions that resulted in good outcomes for your patient. Describe the outcomes that you achieved. 2. How in your practice do you individualize care to ensure the best outcome and implement interventions that address patients beliefs and values. Give examples. 3. Provide examples of how you work with the interdisciplinary team to improve outcomes. 4. Discuss how you function as a resource to others especially in your area of expertise. 5. Describe your experience in mentoring/precepting students or other nurses. What did you do to support the successful transition/advancement of the preceptee/mentee? Include outcomes (How quickly did the nurse preceptee progress, what is your current relationship with the preceptee, does he/she still come to you for guidance?). Or Case Study- Template pg. 14 Use the following outline for the Case Study. All 7 points must be included I. Description of the Case II. Assessment: How did you assess the situation? What data did you use? Did this situation involve the collection of data for Performance Improvement or research? III. Problem Identification or Nursing Diagnosis: From your assessment of this clinical situation, develop your problem list. IV. Implementation (Interventions Selected) a. What actions did you take to address the problems that you identified? Identify clinical pathways, plans of care, or clinical practices used in this situation. b. How did the actions you selected ensure the best possible outcomes for your patient? c. How did your actions demonstrate the collaborative approach to delivering seamless health care services across various settings? V. Evaluation: (Include Patient Outcomes and Key Performance Indicators). Include how you identified changes in a patient or in the patient care situation that led to an improved outcome for your patient. VI. How did you advocate for this patient or group of patients and how did this result in improved outcomes or in a change in unit or hospital policy with regard to this patient or group? VII. Identify how what you have learned in this case has led to improvements in your practice. 2016 5
Education Questions and Documentation Complete all three sections 1. Self-Education: How has your continuing education beyond basic required competencies improved your clinical practice? Provide a written example of what you have learned and how you have applied it in your practice. Achievement of certification in area of specialty (Encouraged but not required). Complete the template on pg. 15. DO NOT INCLUDE COPIES OF CE CERTIFICATES 2. Peer Education: How have you served as a Clinical Resource for nursing students, and/or nursing colleagues in the care of a particular patient population? Complete the template on pg. 16 Examples may include: Materials presented at staff meetings/informal programs Preceptor for students, orientees Presenter for competency days/equipment fairs Instructor for BLS or other educational program Provide proof 3. Patient/Family/Community Education: How you have developed, implemented and evaluated individualized teaching plans for a patient/family or the community? Complete the template on pg.17 Examples may include: Patient education materials developed and/or revised Patient teaching sessions conducted on the unit Coordination of a community project such as a table at a health fair Involvement in a patient education committee or group Provide proof 2016 6
Shared Governance Documentation template pg. 18 1. How do you participate/contribute to patient care/unit/hospital or professional decision-making? Give a personal example based on one or more of the following: The Clinical Resource should demonstrate competence in the mastery of the following: Staff nurse skills considered critical in professional governance models include: 1. Demonstrates ability to engage in decision making about patient management issues. (Examples: Is a vocal advocate for patients with family and other health care providers; does not shy away from controversy over patient management issues; has an adequate knowledge base to participate in decision making regarding treatment.) 2. Demonstrates ability to engage in the development of standards of practice. (Examples: Knows what current standards are for patient population served; is aware of current nursing/health care research in specialty area; has worked on committees to set standards of practice for the unit.) 3. Demonstrates ability to engage in Performance Improvement (PI) monitoring. (Examples: Is active on unit-based PI committee; is knowledgeable about nursing department QA program; can state desired outcome measures for patient population served on the unit.) 4. Demonstrates expert conflict resolution skills. (Examples: Rarely requests/needs intervention by managers to solve conflicts; manages intra- and inter-departmental conflicts in a constructive way; has acquired formal skills in conflict management via continuing education.) 5. Demonstrates expert negotiation skills. (Examples: Is able to negotiate requests for scheduling with peers; is able to negotiate with patients in the setting of patient goals; has acquired negotiation techniques in formal continuing education programs; is able to identify situation where negotiation is an alternative to win-lose situations.) Reeves, S. (1991). Professional governance: assessing readiness of an organization for change. Master s thesis. University of New Hampshire; Durham, NH. Provide written proof such as signatures from chairpersons, educators, managers or members of the interdisciplinary team. 2016 7
Research Documentation template pg. 19 See: Does your Study Need IRB Approval Decision Tree (Meridian IRB webpage) Describe how you participated in a Performance Improvement (PI), Evidence Based Practice (EBP) or research project, independently or in a group. Documentation and Proof: Document your project using the Project Template on the following page. Activities must be verified on the Project Template by the Project Leader, a unit or department leader. Examples include:. Participation in PI, EBP or research project on a unit as a champion, data collector etc. Identifies problems or questions for PI Project or research study and works with educator/researcher Do not include copies of articles, policies, protocols or full research proposals. 2016 8
Portfolio Evaluation Your portfolio will be evaluated based on the following indicators for each section. Clinical Practice Indicators These are the indicators that will be used to evaluate your clinical practice. 1. Anticipates the likely course of events and implements appropriate nursing interventions. 2. Based on past experience, individualizes care to ensure the best outcome and implements interventions that addresses patients beliefs and values. 3. Routinely consults with the interdisciplinary team. 4. Serves as a resource to others especially in area of expertise. Education Indicators These indicators will be used to evaluate the Education section of your portfolio. 1.. Demonstrates a knowledge base of a particular patient population. 2. Provides specific and explicit guidance to clinicians and clinical fellow. 3. Coordinates patient/family/community education for specific population. Shared Governance Indicators These indicators will be used to evaluate the Shared Governance section of your portfolio. 1. Collaborates with RN s on Unit, Nutrition, PT/OT, and Physicians. 2. Manages initiatives to facilitate change for identified groups of patients/families/unit or community 3. Facilitates effective unit functioning Research Indicators 1. Contributes to PI, EBP or research projects as defined by key performance indicators. 2. Includes bibliography/reference list. 2016 9
CARE: Clinical Advancement and Recognition of Excellence Program Level III: Clinical Resource Description: The nurse who progresses to the Clinical Resource, Level III, displays an in depth understanding of the clinical picture as a whole rather than in its specific aspects. The Clinical Resource has learned from past experiences what to expect in particular situations and modifies actions and goals in response to these events. The Clinical Resource has gained experience in working with particular patient populations and is proficient in their care. An experience based aptitude to recognize the whole situation allows the Clinical Resource to anticipate the likely course of events and to appreciate when the expected normal situation does not materialize. He/she can often detect clinical deterioration or patient problems and tailors care and interventions to ensure the best patient outcomes. In selecting interventions, the Clinical Resource takes into consideration the individual patient beliefs and values. The Clinical Resource is recognized by peers as a resource in the care of specific patient populations in his/her area of specialization and uses acquired in-depth knowledge about the care of a particular patient population to affect patient outcomes. He/she provides specific and explicit guidance to clinicians and clinical fellows in patient care situations and positively influences the clinical practice of other nurses and colleagues. The Clinical Resource consults and contributes to the work of the interdisciplinary team and serves effectively on hospital/system work groups and initiatives to strengthen a more effective patient centered care environment. The clinical resource understands the necessity of evidence based practice and is able revise policies to reflect best practice. He/she participates in the design and or implementation of PI and/or research projects. 2016 10
CARE: Clinical Advancement and Recognition of Excellence Program Portfolio Cover Sheet This application is: New/Advancement 3 year Renewal Name: Home Address: Credentials: City: State: Zip: Telephone: Main: Name Change (If applicable) Work: E-Mail: Hospital: Unit: Date of Hire: Current Clinical Recognition Level: No. of Years at this Level: Level of Application: Clinical Fellow Clinical Resource Clinical Scholar National Nursing Specialty Certifications Held: (Does not include BLS, ACLS) Highest Degree: Diploma Associates Bachelors Masters Doctorate No. of Years in Nursing: No. of Years working with current patient population: The Magnet Model Components and the Forces of Magnetism are listed on pages 3 and 4. Below, identify the force(s) exemplified in each area of your application and briefly describe why. 1. My Clinical Practice exemplifies Force because 2. My Educational Activities exemplify Force because 3. My Shared Governance Activities exemplify Force because 4. My Research activities exemplify Force because For office use only: Date Received: 2016 11
Meridian Health System CARE: Clinical Advancement and Recognition of Excellence Program Manager Endorsement for Advancement Directions: Complete and submit this form to your Manager. Name: Unit: Date: Current Clinical Ladder/CARE Level: Level of Application: Applicant s Signature: To be completed by the Manager: (Please complete and return to applicant or CARE program committee) Satisfactory Performance Review Score At last Review: Has employee had any significant infractions/disciplinary notices over the past year? I have been given the opportunity to review this portfolio and I support this employee s application for maintenance Yes No Yes No Yes No If no, give rationale for non-support: Manager Signature Date: Print Name 2016 12
Name: Date: Clinical Practice Questions Discuss the following as they relate to your clinical practice. Provide specific examples whenever possible. 1. Discuss specific patient care situations where, because of your acquired knowledge base, you anticipated a likely course of events and implemented nursing actions that resulted in good outcomes for your patient. Describe the outcomes that you achieved. 2. How in your practice do you individualize care to ensure the best outcome and implement interventions that address patients beliefs and values. Give examples. 3. Provide examples of how you work with the interdisciplinary team to improve outcomes. 4. Discuss how you function as a resource to others especially in your area of expertise. 5. Describe your experience in mentoring/precepting students or other nurses. What did you do to support the successful transition/advancement of the preceptee/mentee? Include outcomes (How quickly did the nurse preceptee progress, what is your current relationship with the preceptee, does he/she still come to you for guidance?). 2016 13
Name: Date: OR Case Study Use the following outline for the Case Study. All 7 points must be included II. Description of the Case VIII. Assessment: How did you assess the situation? What data did you use? Did this situation involve the collection of data for Performance Improvement or research? IX. Problem Identification or Nursing Diagnosis: From your assessment of this clinical situation, develop your problem list. X. Implementation (Interventions Selected) a. What actions did you take to address the problems that you identified? Identify clinical pathways, plans of care, or clinical practices used in this situation. b. How did the actions you selected ensure the best possible outcomes for your patient? XI. How did your actions demonstrate the collaborative approach to delivering seamless health care services across various settings? XII. Evaluation: (Include Patient Outcomes and Key Performance Indicators). Include how you identified changes in a patient or in the patient care situation that led to an improved outcome for your patient. XIII. How did you advocate for this patient or group of patients and how did this result in improved outcomes or in a change in unit or hospital policy with regard to this patient or group? XIV. Identify how what you have learned in this case has led to improvements in your practice. 2016 14
SELF EDUCATION TEMPLATE Name: Date: Type of Education beyond required competencies (seminar, presentation, lecture, poster, school): Date(s) of Education: Topic/title of Education: Description of topic content: How have you applied the knowledge you have gained to your clinical practice? 2016 15
PEER EDUCATION TEMPLATE Name: Date: Type of Education (presentation, lecture, poster, precepting): Date(s) of Education: Who did you educate? Topic/title of Education: Did you provide any written material? Describe and/or list handouts: Description of topic content: What feedback did you receive? Leader signature: Print name: Signature of attendees or signature of person who can verify the above to be accurate. (Sign in sheets can be attached). 2016 16
PATIENT/FAMILY/COMMUNITY EDUCATION TEMPLATE Name: Date: Type of Education (presentation, lecture, poster, skills): Date(s) of Education: Who did you educate? Topic/title of Education: Did you provide any written material? Yes No Describe and/or list handouts: Description of topic content: What feedback did you receive? Signature of attendees or signature of person who can verify the above to be accurate. (Sign in sheets can be attached). Signature: Print name: 2016 17
Name: Date: Shared Governance Documentation 1. How do you participate/contribute to patient care/unit/hospital or professional decision-making? Give a personal example based on demonstrateing growth toward the mastery of the staff nurse skills considered critical in professional governance models. Provide written proof such as signatures from chairpersons, educators, managers or members of the interdisciplinary team. Print Name & Title: Signature: Print Name& Title: Signature: 2016 18
Name: Date: PROJECT TEMPLATE (Must be within the past 3 years) Name or Title of the project: Project Purpose: (What is the purpose of this project?) Project Team Members: (names of anyone else involved in the project) Your role in the project: (What did you do?) Question or PI Problem: (What is the question to be answered? What was the problem to be resolved? ) Methodology: (Who or what was studied? What data collection tool was used? How many subjects/situations/charts were reviewed?) Data Analysis: (How was the information analyzed?) Summary of results: (What were the results? How were they applied? What was the final outcome? If project is ongoing, what are the results to date? ) Bibliography: (What references were used, articles, policies, etc.) Was this project presented? Unit meeting Hospital/System meeting/conference Local/Regional/National Meeting Leader Signature: Print Name: 2016 19