Highest recognition of a health care organization’s attainment of excellence A seal of approval for quality nursing care Recognition of facilities that uphold the tradition of professional nursing practice Established by ANCC in 1993 A culture supporting professional practice Currently 378 Magnet Designated Hospitals – approximately 6% of US hospitals 16 Virginia hospitals with Magnet designation Bon Secours Memorial Regional - 2009 Bon Secours St. Mary’s Hospital - 2008 Carilion Roanoke Memorial-2003 Centra Health Lynchburg General-2005 Centra Health Virginia Baptist – 2005 Inova Fair Oaks - 2009 Inova Fairfax – 1997 Inova Loudoun – 2006 Martha Jefferson – 2006 Martha Washington Hospital - 2009 Montgomery Regional Hospital - 2009 Reston Hospital (HCA) – 2007 Sentara Norfolk General Hospital - 2008 UVA – 2006 VCU – 2006 Winchester Medical Center - 2008 Greater recognition within the community for nursing and the hospital Improved patient care outcomes Improved nurse-physician relationships Competitive marketing advantages Improved recruitment and retention of nurses, physicians and other healthcare professionals Enriched nursing staff satisfaction An opportunity to deploy a group of nurses to make a change – revisiting current practices - is change warranted? Magnet Culture has no fear of failure and modeled, accepted and absorbed by all Nursing Strategic Plan = Roadmap with all levels of nursing contributing This component focuses on the CNO – someone who is capable of transforming the nurses and the culture Nurses are guided, mentored, coached, and educated - consensus decision used Showcase your nurses to promote their image Shared decision in the workplace – shared governance, unit based decision, task forces, interdisciplinary teams Shared decision making in the profession – professional associations, presenting and publishing, competency and certification Partnerships with schools of nursing Nurse in the model = RN Use ANA Principles of Nurse Staffing - the ANCC does not say you have to use selfscheduling but it is an excellent way to demonstrate collaboration Staffing and scheduling process must consider acuity, patient population needs as well as variations in patient population Expectations in this component include – interdisciplinary care, accountability, competence and autonomy Resources for nurses in this component include ANA Code of Ethics for Nurses, ANA Bill of Rights for Nurses and safeguarding privacy, security and confidentiality Nurse sensitive indicators, patient satisfaction and nurse satisfaction at or above national benchmark Must be able to differentiate between Professional Practice Model and Care Delivery System More heavily weighted for Magnet facilities seeking redesignation especially innovation Quality Improvement Evidence Based Nursing – using the latest EBP to guide changes Research – systematic search for knowledge about important nursing issues Nursing Research is aligned with the mission, vision and values; fits with the strategic plan, and will provide value to the facility Research and Magnet Model Research must be integrated into clinical and operational processes Nurses are educated about EBP and research and support human subjects rights Published research is systematically evaluated and used by nurses at all levels Nurses serve on the IRB - review and vote on nursing research proposals Knowledge gained through research is disseminated to the nurses Resources in place to support the advancement of EBP and research in all clinical settings Nursing research studies from the past 2 years, ongoing and completed are outlined in a table which includes study title study status principal investigators (PI) name(s) PI credentials role(s) of nurses in the study study scope (internal to a single organization, multiple organizations within a system, independent organizations collaboratively) study type – replication – yes or no; qualitative, quantitative or both Document one completed research study and describe *purpose and background *how the work was done (methods or approach) *discuss who was involved *what units participated *measurement used to evaluate the outcomes and the impact The organization must disseminate knowledge generated through nursing research to internal and external audiences Quality outcomes related to nursing Clinical practice related to patient care Dynamic and define areas of improved performance as well as additional efforts needed to achieve improvement Most are graphically depicted 19 outcomes throughout the other 4 components Nursing Research Council leads EBP and Research Initiatives RU partnership provides credibility and expertise A growing culture of excellence and innovation EBP five-step Model: Uncertainty to an answerable question Retrieval of best evidence available Critical appraisal of evidence for validity and applicability Application of results in practice Evaluation of performance Gaining comfort with uncertainty Moving clinical problems to searchable/answerable questions PICOT format Music Therapy in Surgical Services Skin to Skin Contact in Obstetrics Bedside Reporting Conflict Engagement Implementing Bedside Reporting: Enhancing Patient Safety n Pamela Lindsey MSN RN; Melissa Aaron BSN, RN Margaret Crigger RN ONC; Kenneth Perkins BSN RN ONC Introduction Patients in hospitals today are more informed and more involved in their care than in the past. With the advancement of technology, patients are living longer and have more opportunities to participate in their care. There is evidence that active patient participation in care produces better health outcomes. Bedside nurse shift report is a process where nurses provide shift-to shift report at the patient’s bedside. Bedside reporting allows the patient access to his or her immediate care and health information and promotes patient ease of mind leading to a speedier recovery. Bedside reporting also assists nurses in prioritizing patient care and managing their patient load effectively, therefore, providing patient-centered care and enhancing patient safety. Background Standard • Verbal reporting between nurses at the nurses’ station • No staff involvement with patient Patent Centered Care AIDIET Format Communication • A standardized shift report is utilized during report • Lengthy report, including irrelevant information that fails to address the needs of the patient Results Methodology SBAR Format • Bedside Report-Required method for nurses providing a hand-off report • Patient and/or family involved in planning care • • • • • A- Acknowledge patient I- Introduce yourself and manage up D- Duration E- Explain T- Thank you • • • • S-Situation B-Background A-Assessment R- Recommendation 1= Nurse satisfaction scores from pre and post survey 2= HCAHPS Survey score pre and post implementation 3= Patient call back survey pre and post implementation Bedside Reporting 98% 95% 98% 78% 55% Key Components 98% • Trace all lines and tubing from the point of origin to site or collection device 1 2 Pre Intervention Handoff • The patient/family is seldom involved in the process with no formal means to communicate needs and concerns • Does not incorporate patient-centered care Report Format Time constraints • Patient name, diagnosis, and procedure since admission • Changes in patient’s condition or episodic event • Individualized report takes about 3-5 minutes 3 Post intervention Bibliography Anderson, C.,Mangino, R. (2006). Nurse Shift Report: Who Says You Can’t Talk in Front of the Patient? Lippincottt Williams and Wilkins, Inc. Nurse Admin Q. Vol. 3 pp.112-122. Hemant K Kassean and Zaheda B Jagoo (2005). Managing change in the nursing handover from traditional to bedside handover – a case study from Mauritius BMC Nurs.;4: 1. Published online 2005 January 28. doi: 10.1186/1472-6955-4-1 PMCID: PMC548693 Kim Alvarado, Ruth Lee, Emily Christoffersen, Nancy Fram, Sheryl Boblin, Nancy Poole, Janie Lucas and Shirley Forsyth. (2006). Transfer of Accountability: Transforming Shift Handover to Enhance Patient Safety Healthcare Quarterly, 9(Sp) 75-79 IRB consolidation/mentoring Research consortium Dress Study MRSA Guidelines Wound Staging Continuing Education Opportunities Local Regional National ICU Quiet Times Dedicated Education Unit Care Delivery Models Hypothermia approaches in the ED Bedside reporting-validation study “Improved statistics would tell us more of the relative value of particular operations and modes of treatment… and the truth thus ascertained would enable us to save life and suffering.” Application Manual, Magnet Recognition Program (2008) Aravind, M. & Chung, K. (2009) Fineout-Overholt, E. &Johnston, L. (2005)