Nurses Matter: The Role of the Nursing Support Program I (NSP I) in Maryland

Transcription

1 Nurses Matter: The Role of the Nursing Support Program I (NSP I) in Maryland Miriam Haviland PHASE Presentation Maryland Department of Health and Mental Health Services May 10 th, 2013

2 Presentation Overview Value of nurses in the U.S. health care system NSP I background NSP I evaluation Data sources and methods Findings NSP I and IOM recommendations for the future of nursing

3 The Value of Nurses Largest group of providers in the health care system Nurses impact patient outcomes Time spent with patients Education Job satisfaction

4 Overview of HSCRC The Health Services Cost Review Commission (HSCRC) is an independent agency with authority to regulate 47 acute care hospitals in Maryland. Because of its authority, HSCRC is able to fund programs to address hospital nursing staff needs through rate increases.

5 NSP I Background Originally funded in July of 2001 to address the nursing shortage in Maryland Program provides participating hospitals with up to 0.1% of gross regulated patient revenue for activities Goal of the program is to recruit and retain high quality nurses in Maryland hospitals Funding renewed in July of 2012 for another 5 years

6 The Need for Evaluation of NSP I Review previously unanalyzed qualitative data Facilitate coordination and discussion of best practices among participating hospitals

7 Data Sources NSP I Coordinator Reports FY2009- FY2012 FY2013 NSP I Hospital Program Descriptions Site Visits conducted during April 2013

8 Methods: Coordinator Reports FY2009-FY2012 Reviewed five qualitative questions regarding activities to improve the nursing environment Identified and coded common activities and programs

9 Methods: FY2013 Program Description Programs broken into three categories: 1. Education and Career Advancement 2. Patient Quality and Satisfaction 3. Advancing the Practice of Nurses Activities were extracted and sorted into thematic categories

10 Methods: Site Visits Four site visits conducted by HSCRC staff during April 2013: MedStar Harbor Hospital LifeBridge Northwest and Sinai Hospitals MedStar Union Memorial Hospital Mercy Medical Center

11 Findings: Coordinator Reports Shared Governance Evidence Based Practice (EBP) Initiatives Implemented Nurse Quality Indicators Applied Nurse Research Projects New approaches to staffing and patient allocation Councils Retreats and other governance trainings Quarterly newsletter Governance training Created EBP fellowship (GBMC) Councils review literature and implement EBP Support EBP research EBP training workshop Subscription to NDNQI Increased number of nurses with certifications Training and evaluation on patient safety initiatives Research councils EBP research practices and initiatives Online research education programs Nursing staff involved in Unit Design Electronic scheduling Subscription to Nurse Sensitive Quality Indicator database

12 Findings: FY2013 Program Descriptions Scholarships for Nurses Nurse Residency Programs Mentoring Programs Resource Subscriptions Evaluation of Nursing Practices Governance Support for Special Staff Training Programs Initiatives to Support Nurses work Outreach Fellowships Acknowledgements Evidence Based Improvements in Nursing Environment and Practice Other Initiatives

13 Findings: Site Visits Hospital Date of Visit Primary Program Activities Feedback on NSP I MedStar Harbor Hospital 4/5/13 Scholarships for Nursing staff (RN BSN and BSN MSN) Very appreciative of NSP I funds. Program is improving nursing talent and job satisfaction. MedStar Union Memorial Hospital 4/26/13 Nurse Extern Program Funding from NSP I has helped to provide extra training to nursing students, especially in areas of critical care and time management. Many externs become hospital employees and are better prepared to enter the workforce.

14 Findings: Site Visits Hospital LifeBridge Northwest & Sinai Hospitals Date of Visit Primary Program Activities 4/26/13 Nurse Residency Program (Project Connect) Mercy Medical Center 4/29/13 Magnet hospital activities Preceptor program High School outreach Feedback on NSP I Funds from NSP I are helping to improve nursing quality by assisting newly graduated nurses as they transition from the classroom to the units. Funding from NSP I has helped improve nurse job satisfaction. It has also helped staff collect data on their activities to better evaluate nursing quality in their hospital.

15 Limitations Annual Reports FY2009-FY2012 Two questions were not asked on the FY2009 and FY2010 Coordinator Annual Report Low response rate FY2013 Program Descriptions New Instrument Site Visits Limited standardization

16 NSP I in the Context of the IOM Recommendations for Nursing Eight IOM recommendations are organized into four major categories: 1. Nurses should practice to the full extent of their education and training 2. Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression 3. Nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the United States 4. Effective workforce planning and policy making require better data collection and an improved information infrastructure.

17 Concluding Remarks NSP I is an effective program for Maryland nurses, hospitals, and patients Overwhelming feedback indicate that the program has made a significant difference in the quality of nursing care and nurse job satisfaction

18 Acknowledgements HSCRC Preceptors Claudine Williams Oscar Ibarra NSP I Coordinators PHASE Staff Jennifer Le Beth Resnick