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Newsletter Winter 2010 » download pdf |
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FROM THE DIRECTOR
ALOHA KAKOU
Did you know that over 500 RNs and LPNs have completed the
center’s Nurse Leadership Workshop? And there are 24 Evidenced Based
Practice (EBP) teams participating in an 18 month internship program
actively supported by the center? These are just two of the very successful
programs offered in support of the centers major functions; conduct
research on best practices and quality outcomes; and develop strategies
to retain nurses. EBP workshops are offered annually for new teams and
leadership workshops are offered throughout the year. Dr. Marita Titler in
partnership with the center will be offering an Evidenced Based Practice
workshop on April 5, 6, and 7, 2011. Visit our website www.hinursing.org
or call 956-5211 for more information.
In 2011 the biennial RN survey will be conducted and available on-line
as part of the electronic license renewal. Results of the survey provides
health care providers, employers, legislators, educators, insurers, and
the nursing community at large with important nursing workforce data
and information for planning and funding purposes. Although voluntary,
on-line completion of the survey is highly encouraged, your participation
contributes to ensuring that the State of Hawaii has the nursing resources
necessary to meet the health care needs of it’s people. Collecting,
analyzing and reporting workforce data is another important function of the
center.
In the 2009 RN survey, a section for new graduates was included
regarding employment opportunities. Results indicated they were offered
their first RN position within six months of graduation. However, we are
aware that the current situation is different. Demand for new graduate
RNs is very low, especially in acute care. This is a national as well as
local phenomenon and it has local health care providers concerned. In
response to the concern, a collaborative of providers and academic
partners have agreed to implement a nationally recognized Nurse
Residency Program. The center serves as the organizer and facilitator of
the collaborative to acquire and implement the program in 2011.
These are but a few of the programs actively underway with more to
come. We are very appreciative of your support and that of our partners.
We also welcome your involvement and feedback, please visit our website
at www.hinursing.org.
Mahalo Nui Loa,
Gail Tiwanak, MBA, RN
Institute of Medicine (IOM) “The Future of Nursing: Leading Change, Advancing Health”
http://www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.aspx
to view the summary report, recommendation report or to purchase the report. |
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Hawai’i Nurses in Partnership
Forecasts indicate Hawaii will experience a growing shortage of nurses over the next 10 to 20 years as the largest segment
of the current working population, the Baby Boomers, retire and leave the profession. The growing shortage of staff nurses is
expected to create a shortage of nurse leaders. To address this issue the Hawaii State Center for Nursing developed and began
offering the nurse preceptor program in May 2008, to ensure adequate succession planning for future registered nurses practicing
professionally in our health care system.
A five-day intensive course “Clinical Coaching Development” designed by Vermont Nurses in Partnership was offered to selected
staff from four acute care healthcare settings across the State. The major objective of the course was to assist participants in
establishing protocols for internship program delivery and initiate tools and resource customization that will meet the needs of
individual healthcare organizations. The goal of the program was to provide instruction and resources for establishing a preceptor
empowering work environment in the participating organizations. The intensive covered content in five areas:
• Preceptor workshop planning
• Intern/preceptor program implementation
• Customization of competency tools
• Development of coaching plans
• Initiation of a collaborative work plan
To date, over 500 licensed nurses (i.e., registered nurses, licensed practical nurses) from acute care settings have participated in
the internship program. After completion of the program, participants (preceptors and new interns) were asked to complete several
evaluative questionnaires to measure the perceptions of workplace support, satisfaction and program effectiveness.
Preceptors and New Interns
The questionnaires used a 5-point Likert scale with 1=strongly disagree, 2-somewhat disagree, 3= don’t disagree or agree; 4
somewhat agree, 5=strongly agree. Preceptors were asked to select the level of agreement/disagreement for each item statement
on the questionnaire. Each item statement was framed in context to the preceptor teaching the interns. The new interns were
asked to select the level of agreement/disagreement with each item statement in reference to what they learned or how they
developed during the program. The mean scores shown in Figure 1 reveal responses were similar between preceptors and new
interns.
Figure 1: Perceptions of Workplace Support, Satisfaction and Program Effectiveness
After the clinical internship phase of the program was
initiated, new interns were evaluated to track their
competency progression. As shown in Figure 2, the new
interns demonstrated progressive improvement in the
seven assessment areas between week-1, week-5, and
week-10. The highest mean scores were found in the
assessment areas; Leadership & Management, Human
Caring & Relationship, and Safety/Technical/Clinical.
Figure 2: New Interns Clinical Progression
Program evaluation data indicates a greater percent of the
participants agreed the program provided; an orientation to
their preceptor or intern role, organized and efficient teaching
methods, clinical experiences to meet learning needs,
resources and support. A large percent of preceptors and new
interns also reported they would recommend the program to
others. |
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Pacific Institute of Nursing Conference
March 2010
Executive Summary
The 2010 Pacific Institute of Nursing Conference is sponsored, in part, by an Agency for
Healthcare Research and Quality grant. The purpose of this grant is to assist with the
dissemination of knowledge to improve outcomes, quality, and access to health care services in
Hawaii through implementation of evidence-based practice. This regional research dissemination
and translation conference entitled “Pacific Institute of Nursing: Advancing Practice, Education and
Research” was held on March 29 and 30, 2010 at the Waikiki Prince Hotel in Honolulu, Hawaii
and fulfilled its goal of reaching nursing administrators, clinicians, educators and researchers from
Hawaii and beyond. With more than 250 attendees, it was gratifying to have excellent participation
from a broad range of nursing fields as well as across the continuum of care from acute to long
term care, including hospice and home care. Many students attended as well.
With just 3 months in which to organize the conference, the Planning Committee, comprised of
members from more than twelve educational and healthcare organizations, worked very efficiently
to make the critical decisions and identify potential presenters, solicit vendors and market the
conference to future attendees. The Key Note speaker, Dr. Patricia Benner, was outstanding as
she spoke compellingly on radically transforming the educational training of nurses. It was thought
provoking, but rewarding for listeners, as the following day’s panel presentation by University of
Hawaii School of Nursing and Dental Hygiene (UHSONDH) faculty on Articulated Curriculum and
its Application to Practice and Education clearly met many of the recommendations made by Dr.
Benner. The conference also had two post lunch speakers, one of whom spoke on understanding
Congress’s legislative process as it related to national health care reform, while the other
focused on strategies for nurturing nurses. Both speakers received the highest marks for plenary
presenters.
There were a total of thirty-six podium presentations and twenty poster presentations. Six of the
podium and one poster presentations were made by the Evidence Based Practice Class of 2009.
All Abstracts were posted on the PIN website for pre and post conference accessibility.
A two and one half day Evidence-Based Practice (EBP) Workshop was held immediately following
the 2010 PIN Conference. As in the past two years, Marita Titler, Ph.D. the creator and architect of
the Iowa Model for developing an EBP project led the Workshop. Twelve projects were initiated by
teams from seven organizations and while most were acute care oriented, the target populations
ranged from pediatric to gerontology patients and one project focuses on emergency responses
in out-patient settings. This is an intense two and one-half day workshop which requires close
follow-up with each team over the subsequent eighteen month period. All presenters received
good or excellent ratings.
The overwhelming anecdotal and post-conference evaluations highlighted the importance of the
purpose of the conference and the venue. Participants expressed a high interest in evidence
based practice and learning about the on-going and completed projects, the various phases of a
project and outcomes. Evidence Based Practice project poster and breakout sessions were well
attended and registrants noted on their evaluations that they achieved their goal(s) in attending
them. Many expressed interest in participating in a two and one-half day EBP workshop sometime
in the future.
The 2011 PIN Planning Committee has convened, a sub-theme which supports the over-arching
theme of Advancing Nursing Practice, Education and Research has been developed, and key note
speakers have been confirmed. We are looking forward to seeing you there! |
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Call for Proposals
Hawaii State Center for Nursing
Projects to Address
Nursing Recruitment, Retention,
Best Practices and Quality Outcomes
Purpose
The Hawaii State Center for Nursing is pleased to present – the HSCFN call for proposals to support initiatives to Address Nursing Recruitment,
Retention, Best Practices and Quality Outcomes in the Workplace. The grant funded program will serve as a model and will facilitate future
efforts to fund a variety of projects through Center resources and/or with solicited external funds. The funded initiatives are intended to capture
information and help identify effective solutions to maintaining and expanding the nursing workforce in Hawaii. HSCFN will evaluate and report
the results of these efforts. The HSCFN Advisory Board may incorporate said results into recommended systemic changes, including strategies
for implementation, presented to the legislature and others.
Eligibility
Funded initiatives may be at the facility, local, regional or state-level, and are open to individuals or groups. Projects may or may not relate to a
specific workplace setting (i.e. acute care, long-term care, home health, pubic health, ambulatory care, academic settings) that employs RNs,
LPNs, and/or APRNs. The applicant must be a nurse and at least one staff nurse must be included as a team member.
Background
The Hawaii State Center for Nursing believes that an approach to resolve the nursing shortage in our state is to improve the retention, best
practices and quality outcomes in healthcare work settings. This includes improving the image of nursing and creating work environments that
support the practice of nursing. The quality of care delivered is dependent on the skills and knowledge of care providers. The loss of experienced
nurses results in a loss of essential skill and knowledge.
It is anticipated that one to three initiatives will be awarded per year. Grants awards may be up to $10,000. The HSCFN will convene an external
committee who will review, prioritize, and report their results and recommendations to the HSCFN Advisory Board.
Applications are encouraged in the following areas, including but not limited to research or projects that:
♦ Obtain direct input on issues and solutions from high-risk nurse populations
o Relate to the fostering and retention of first-line managers
o Support the retention of first-year novice nurses providing direct care
o Support the retention of the maturing nursing workface in Hawaii
♦ Examine the experiences of front-line managers in retaining staff nurses
♦ Identify the satisfiers and non-satisfiers for nurses providing direct care
♦ Relate to regional successes and challenges of retention within Hawaii
♦ Examine the physical work environment and/or the culture of the work environment
♦ Relate to nurse recognition programs (i.e. Magnet©, Beacon, Baldrige)
♦ Serve as a pilot for long-term or large scale workplace initiatives (e.g., best practice or quality initiatives)
Application
Proposals will be accepted on or before, but no later than, the close of business Friday, 5:00 p.m., April 15th, 2011. No proposal will be
accepted after this date.
The notice of awards will be published on the HSCFN website http://www.hinursing.org.Funded initiatives may be funded for 6 to 12 months.
Quarterly progress reports will be required in October, January, April, and July. A comprehensive final report will be due 90 days after completion
of your project. Projects lasting less than one year will have individually set reporting structures. At a minimum, the abstract (with contact
information) of the final report will be stored in the HSCFN’s best practice repository and posted on the HSCFN website.
Proposals must include all of the following elements:
1. What is the specific problem your initiative addresses?
2. What is the significance of the problem on the setting, patient population and nursing workforce?
3. What are the key components or activities to be examined and measured?
4. What are the expected outcomes or products of the project?
5. Who is the intended audience for this initiative?
6. How will results be shared with intended audience?
7. What methodology will be used?
8. How would you define success for this initiative?
9. How does your initiative capture information that will help identify effective solutions to maintaining and/or expanding the nursing
workforce in Hawaii?
10. What is your budget and budget justification? Do you anticipate other funding sources? If yes, what are they?
11. What are you dissemination plans for presentation at local and/or national conferences and publications?
Format proposals using an Arial 12-point font with one-inch margins, double-spaced, and limit to 10 pages (excluding references).
Submission of Proposal
Download the application form. Proposal must be submitted to Gloria Shishido at glorias2@hawaii.edu no later than the close of business on
Friday, 5:00 p.m., April 15th, 2011. Only electronic submissions in Word DOC format will be accepted. Questions may be directed to the Hawaii
State Center for Nursing by email to glorias2@hawaii.edu or by phone (808) 956-5211.
Budget Constraints
Funds may not be used for travel to attend conferences.
Indirect charges greater than 5% of total direct costs are not permitted.
The use of funds for equipment is permitted only if the equipment is integral to the research and is not available within the department,
institution, or center.
Evaluation Criteria
Required
Degree to which the proposed work supports the Center’s goals of directing and prioritizing nursing retention efforts in Hawaii
Potential for use in nursing practice, serving as a best practice, and/or establishing bench marks.
Feasibility (i.e. timeline, work plan, budget, scope)
Innovativeness
Scientific and/or technical merit of the proposed initiative
Applicant’s expertise for conducting proposed initiative (i.e., Curriculum Vitae)
Preferred
Use of funded initiatives as matching support to other agencies or organizations
Plan for acquiring additional funding from other sources |
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EBP Project: “Why Starting Early and Being Quiet Matter”
Although Florence Nightingale first used evidence to gather support for and institute major changes in the profession of nursing, emphasis
on evidence-based practice (EBP) has waxed and waned. Fortunately, EBP is now recognized as a cornerstone of quality nursing care. In the
previous newsletter, an innovative practice initiative designed in part to increase the understanding and use of EBP methods statewide was
reported. Briefly, a two-day workshop given by Dr. Marita Titler launched this 18-month program designed to mentor the workshop attendees.
This article discusses two successful projects supported by the program. Two dyad teams from Tripler Army Medical Center (TAMC) attended
the workshop and the subsequent teleconferences. During these teleconferences, teams from around the state would call in and discuss their
projects with subject matter experts. Both projects at TAMC were problem, rather than knowledge triggered, followed the Iowa model of EBP, and
had full institutional leadership support based on the patient-focused outcomes.
VickieAnn Laubach, RNC and Patricia Wilhelm, PhD, RN identified that noise levels in the Neonatal ICU (NICU) exceeded national
guidelines (NRL); a situation detrimental to the growth and development of neonates. Organizationally, plans were underway to remodel the
NICU. The team formed to address the problem included staff RNs, a nursing student, and industrial hygienists to help measure noise levels.
Initially 65 articles were identified in the literature review. A minimum of twenty articles met criteria and were critiqued for strength of evidence
and adherence to NRL guidelines using the AGREE tool. Operational and structural noise reduction measures such as staff education regarding
practice behaviors, monitor alarms, lighting, phones, closing isolette doors, and Quiet Time were identified in the literature. These and other
recommendations were piloted in a mock single family room designed to model proposed unit changes. Noise levels were measured at various
times during the day before and after changes were implemented. Measurable reductions in noise levels were achieved. Both operational and
structural measures for sound abatement have been incorporated into remodeling plans. Changes that can be made prior to reconstruction have
been implemented such as lowering voice levels, lighting, and designated Quiet Time. Data collection regarding outcomes of these changes is
ongoing, but preliminary results indicate noise levels have decreased. Once reconstruction is complete, it is expected that noise levels will be at
or below NRL recommended sound levels.
The second project was initiated by CPT Valarie Palacios, RN and MAJ Jerremie Siegfried, MSN. Despite the volume of babies born at
TAMC, childbirth education classes, especially for first time parents, were not offered at TAMC. Parents requesting these types of classes either
paid out-of-pocket, which were cost-prohibitive for some families, learned from family/friends/internet, or did
not receive education. Additionally, patient satisfaction surveys and anecdotal data indicated a need for this
service. The team consisted of a staff RN, a clinical nurse specialist (CNS), and a master’s prepared patient
educator. Sources of evidence included both a literature review and a panel of experts: childbirth educators,
CNSs, NPs. Over 40 articles were originally identified in the literature. A prepackaged program rather
than individual interventions that could be “bundled” was selected and implemented in 2009. To date, 540
parents have participated in the program. Participants consistently give high satisfaction scores on postclass
surveys and due to the high demand, a full time OB educator was hired.
There are currently 14 active EBP projects at TAMC. The success of these projects can be attributed
to the strong leadership commitment to quality care and patient safety, the mentoring from subject matter
experts through HSCN and at TAMC, and the commitment from these dedicated clinicians.
Disclaimer: The views expressed in this presentation are those of the author(s) and do not reflect the
official policy or position of the Department of the Army, Department of the Defense, or the US Government.
 Childbirth EBP Team 3 and Childbirth EBP
Team 2.
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