Competency Model
• GHS Nursing Initiative
• All Nursing Roles
 Staff (RN, UAPs)
 Preceptor
 CNE
 CNS
 Manager
 Director
 Affiliated Faculty
Faculty Competencies
PHASE
TARGET ROLLOUT
PURPOSE
Healthstream Curriculums
1st Quarter 2014
Provide specific foundational
content to support faculty in
various clinical arenas
Competency Validation
Boot Camps
Spring/Summer 2014
Train the trainer / Validate the
validator
Faculty Competency
Validations
Fall 2014
Ensure faculty competency
Core Regulatory
Curriculum - Clinical
Job Specific Curriculum
Department Specific
Curriculum
Faculty Competencies
PHASE
TARGET ROLLOUT
PURPOSE
Healthstream Curriculums
1st Quarter 2014
Provide specific foundational
content to support faculty in
various clinical arenas
Competency Validation
Boot Camps
Spring/Summer 2014
Train the trainer / Validate the
validator
Faculty Competency
Validations
Fall 2014
Ensure faculty competency
Nursing Safety Initiatives
• CAUTI Prevention (Catheter Associated Urinary Tract Infections)
Faculty Opportunity! We are seeing new
grads struggling with Sterile Technique
• CLABSI Prevention (Central Line Associated Blood Stream Infections)
Faculty Opportunity! We are seeing spikes
on units with new graduate RNs
CAUTI Bundle
•
Appropriate reason for Foley insertion and daily re-assessment of continued need
•
Use sterile technique with Foley insertion
•
Date of insertion on orange sticker on tubing just above drainage bag
•
Foley securement (STAT lock)
•
Keep a closed system (red seal intact)
•
No dependent loops and keep bag below level
of bladder
•
BID Peri/Foley care
Peri-care for Catheterized Patients (updates)
•
•
Peri-care for patients is performed twice a day (i.e. every shift) and whenever the patient is wet or
soiled.
Use facility approved personal cleansing wipes only:
Name of Cleansing Wipes
Use
Color of Packaging
Sage Comfort Bath Cleansing Washcloths
May be used on perineal area and catheter
Blue packaging
Sage Comfort Shield Barrier Cream Cloths
May be used on perineal area; DO NOT USE ON CATHETER
Gray packaging
Sage 2% Chlorhexidine Gluconate Cloth
May be used only if patient is receiving CHG baths
Burgundy packaging
•
•
•
Wash basins are to be immediately disposed of after each use. Never re-use.
It’s important to perform peri-care prior to foley insertion.
- Hand hygiene first
- Use the castile soap wipes first. Females – (3 wipes) one for the left side, one for the
right and the last one for the middle, wiping front to back each time.
- Use the hand sanitizer in the kit before donning sterile gloves.
- Use the povidone-iodine sticks in the same fashion as the castile soap wipes.
Documentation in the patient’s medical record under Nurse/Patient activity should reflect that pericare is done BID and PRN.
CLABSI Bundles
• Insertion bundle
• Maintenance bundle
• Additional measures include:
– Using Curos® caps if indicated
– Daily CHG bathing of the patient
Nurse Extern Program
Feedback
•
In what ways did your experiences as a Nurse Extern differ from your
experiences as a student nurse doing clinicals?
 I was able to have more time one on one with a nurse and ask questions and understand.
 I felt more like a nurse! Providing care to 4 patients is more realistic than only providing bed baths and
performing vital signs one one or two patients. It allowed me to see the bigger picture and to focus
further on time management skills.
 The extern program was completely different from student nursing clinicals. Seeing how many things
nurses have to juggle during the day such as calling doctors, multiple patients, labs, and procedures is
not something that we get to see as students only working with one or two patients.
 I was able to spend more time with patients and get to know them and build a relationship with them. I
feel as though it will strongly help me in the transition to the actual RN schedule as I worked 12 hour
shifts 3 days a week versus doing 8 hour clinicals once a week.
 I loved how I got to work with a nurse one on one compared to a group of 8 in my clinical setting at
school.
 The externship was very educating, having the one on one mentoring taught me so much about "why?"
as a student nurse the focus is much more task oriented.
 I was able to observe more patients and nursing concepts as an extern. As a student, I usually received
one patient each clinical day. However, as an extern, I was able to learn and observe several patients
each day at work.
Nurse Extern Program
Feedback
•
In what ways did your experiences as a Nurse Extern differ from your
experiences as a student nurse doing clinicals?
 I felt like I was really helping this summer as opposed to clinicals where I often just feel like I'm in the
way since we aren't exactly shadowing nurses each day.
 I was able to see the whole process from the nurse's perspective. Understand what it feels like to have
multiple patients.
 As a nurse extern, you get to see what a normal day in the life of a nurse is. This is something you never
see during clinicals since you are only at the hospital for a max of 6 to 7 hours a day
 As a Nurse Extern I was attached to the hip of a mentor where as in clinical I can only do things with my
instructor who is overseeing 7 other students on the floor.
 One-on-one is so helpful. Not having to worry about clinical paperwork, but rather the ac of being a
nurse, was also so very nice.
 I felt like I had a bigger role. Rather than just going "am care" on one patient, I was able to act like a real
nurse and see different kinds of patients. As a student nurse you get one patient and they may only need
one medication for the morning, this always left me bored. This was not the case in the Externship.
 I think it differed because I got to see so much more than in school. Also, without the pressures of care
maps and paperwork and performing skills, I was able to really begin to mentally put the pieces together
of what it meant to be a nurse. I think working 12 hour days instead of just the 8 during school also
allowed me to get a bigger picture of what its like to really be a nurse.
 I felt more independent and in control of my learning experience. I was able to see so much more!
Nurse Extern Program
Feedback
Thoughts?
Thank you!