MARCH The Nursing Professional Practice Committee

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1 MARCH 2009 Introduction Magnet organizations are characterized by Exemplary Professional Practice environments that support accountability, competence and autonomy. In this month s enursingnow we are highlighting how NMH nurses demonstrate exemplary professional practice across our organization. The Nursing Professional Practice Committee By Rebekkah Beil, RN Clinical Coordinator-11W CVT Stepdown The Nursing Professional Practice Committee (NPPC) is charged with overseeing professional nursing practice at NMH to ensure safe, high quality, evidence-based care. The group also oversees the development and revision of nursing policies and procedures. Specific NPPC goals for FY09 include: 1. Integrate the ANA Scope and Standards of Practice, Social Policy Statement, and Code of Ethics into nursing practice at NMH. 2. Develop a plan to imbed the guiding principles of the Henderson Framework for Practice to all areas of nursing at NMH. 3. Develop a plan to disseminate and imbed key principles from the Patient Centered Model of Care to nursing areas throughout NMH. 4. Examine the efficacy of NMH s nursing acuity system, which includes reviewing staffing data as required by the Staffing by Patient Acuity legislation twice yearly. 5. Advance nursing practice at NMH in relation to falls, pressure ulcer prevalence, patient comfort and mobility. 6. Lead the optimization of the IPC as the source of truth in the driver of patient plan of care incorporating Case Management as a key part of the process. This year, the Committee has teamed with several groups on projects directed at attaining its FY2009 goals. Currently, the NPPC is working with staff from the NSICU and Neuro-Stepdown units to develop blogs and presentations to help nurses fully understand the ANA Scope and Standards of Practice, Social Policy Statement, and Code of Ethics and their link to nursing practice at NMH. The blogs and presentations will be available on-line and will be highlighted during Nurses Week this May.

2 NPPC also is working with the Nursing Technology and Informatics Committee (NTIC) and Medicine physicians on a DMAIC project to optimize the Interdisciplinary Plan of Care (IPC) as the source of truth in driving the patient's plan of care. The current IPC is not being fully utilized and the Committee s goal is to bring value to it. Part of this process may involve piloting a new Cerner program that would allow additional information to pull through to the IPC thus supporting increased utilization from all disciplines. Another project that the NPPC is working on is to help imbed the guiding principles of the Henderson Framework for Practice into all areas of nursing. As highlighted in last month's enursingnow, NMH uses Virginia Henderson's theoretical framework to drive nursing practice. As the oversite committee for nursing practice, the NPPC has been charged with familiarizing all NMH nurses with her guiding principles. NPPC is currently brainstorming ways to imbed her principles into each and every Nursing Care Policy, as well as creative ways to familiarize bed-side nurses with Henderson s work. Several Nurses Week activities will feature Henderson s framework and guiding principles. Nursing Professional Practice Committee Members Robert Fortney, RN,MS CNRN, NE-NC Rebekkah Beil, RN,BSN Kathy Blasser, RN Carol Burns, RN Susan Collazo, RN, MSN, ACNP-BC Katie Erickson, RN, MS, MBA Alicia Gayton, RN Kristen Pope, RN Sandra Reiner RN, BSN Yvonne Rucker, RN, OCN Facilitator, Director, Patient Care Administration Neuro-Ortho 11 West Surgical Surgical Services Oncology Thoracic Surgery Quality Stephanie Seburn, RN, BSN CCU Megan Struble, RN Lana Tadros, RN, BSN Tamara Tichenor, RN, BSN Grace Tokarski, RN Jill Vargas RNC, BSN, BS ED/EDOU 15 East Medicine Infection Control Manager Oncology Prentice Northwestern Memorial Hospital Advanced Practice Nurse Credentialing & Privileging Process By Misty Kirby-Nolan MSN, APN, CNP IR NSICU-Neuro-Ortho Float Pool Stone Advanced Practice Nurses play an important role in creating an exemplary professional practice environment at NMH. These nurses have a vital role in meeting the increasing

3 need for clinical and non clinical support both in the hospital and outpatient clinics. APNs serve as advanced clinical nursing experts and physician extenders as well as nurse and patient educators. All four Advanced Practice Nursing specialty areas, Certified Nurse Practitioner (CNP), Certified Nurse Midwife (CNM), Clinical Nurse Specialist (CNS) and Certified Registered Nurse Anesthetist (CRNA) are represented here at NMH. The NMH APN role is extremely diverse across specialties and sub-specialties. Each specialty area has different expectations and requires varied clinical skill sets with specialty specific competencies for their APNs. Solid organ transplant, oncology, endocrine, neurosurgery, cardiac surgery, vascular surgery, palliative care, wound care/ostomy, radiology, nuclear medicine, psychiatry, urology, infectious disease, obstetrics and gynecology, and anesthesia are just some of the areas in which APNs practice. APN practice is guided by the 2008 Illinois Nurse Practice Act. The act requires APNs to have both a registered nurse license and an advanced practice nurse license in order to use the APN title. APNs scope of privileges is based on their education, training and experience. APNs must apply for and obtain clinical practice privileges before they can function in the advanced practice role at NMH. Credentialing and privileging of APNs mirrors the physician process and is facilitated by the Medical Staff Office. APNs must provide evidence of licensure, certification, education and training as well as references. Nursing Directors and supervising physicians review the application. Completed applications and a letter of request for privileges are sent to the Chief Nurse Executive (CNE) for review. The CNE recommends applicants to the Medical Executive Committee (MEC) which in turn recommends these applicants to the Professional Standards Committee (PSC) of the Board for privileges. APN competency is assessed annually. Recredentialing is done biennially and includes review of the APNs scope of privileges by the CNE. The rigorous credentialing process ensures that APNs are operating within the scope of their advanced practice nursing license as well as using their skills effectively to provide the Best Patient Experience. New Patient Throughput Coordinators set to improve patient flow Patients frequently experience long waits times for admission to inpatient beds. Less than half our patients reach a bed within 3 hours of the initial request! Beginning on March 24 th, the new Patient Throughput Coordinator (PTC) nurses will work to improve house-wide flow and decrease admission wait times. The Patient Throughput Coordinators (PTC s) will work in the Bed Assignment office to o Serve as the key contact for daily patient throughput and capacity issues o Collaborate with Bed Assignment, the Hospital Operations Administrators (HOAs), the ED, the PACU, the inpatient units, Care Facilitators and MDs to optimize patient throughput

4 o Prioritize bed requests and work with clinicians to ensure efficient patient placement o Provide point of contact service for direct admission requests o Round throughout the Feinberg Inpatient care and Hematology/ Oncology to collect vital information including potential discharge estimates The PTC s will focus on rapidly placing medicine, surgery and hematology / oncology floor-level patients. The PTC s will not make ICU placements, but will work in collaboration with residents, HOA s and others to facilitate house-wide placement. They will operate 24 hours per day and 7 days per week and have two staff in-house during peak bed request times from late morning to early evening. On March 24 th the following nurses will start as the PTC team: o Christina Guajardo RN, BSN, ED o Enrique Fernandez RN, BSN, ED o Jonathan Barin RN, BSN, CTICU o Jennifer Doyle RN, BA, Float Pool o Patricia Matthews RN, BSN, Surgical Services If you have questions about the new role or processes please do not hesitate to contact Kristin Ramsey , kramsey@nmh.org. Nurse Leaders Katie Linn, RN, Feinberg 12 East is the Chair of the Nursing Technology and Informatics Committee (NTIC). Katie has been a nurse for four years and since that time received the Excellence in Nursing Practice Award in May, Katie has also been a Certified Medical Surgical Registered Nurse since May, She has received recognition for Perfect Attendance in 2006, 2007, and Katie plans to return to graduate school to become a Nurse Practitioner and would like to become a clinical instructor for nursing students. She also hopes to submit a Chapman application and conduct a research study. Katie believes that the Nursing Technology and Informatics Committee (NTIC) has had a tremendous impact on nursing at NMH such as how the use of the electronic SBAR has changed the way that bedside nurses give report. NTIC constantly reviews documentation standards and policies in order to improve documentation and patient care. All technology being considered for implementation that impacts patient care is reviewed and evaluated by NTIC. The committee also serves as a resource for nurses who have questions, concerns, or suggestions about the use of the electronic medical record within their daily nursing practice. Katie Linn, RN, BSN, CMSRN, Feinberg 12East NTIC Committee Chair

5 Accolades Susely Guevara, RN, CMSRN Liliana Alvarez, RN, CMSRN Yuliya Rudenko, RN, CMSRN Marta Szczepanski, RN, CMSRN Helen Tomkow, RN, CMSRN Consolacion Aristoza, RN, CMSRN Rebecca Schuetz, RN, BSN, CVN Corrine Benacka, RN, CCRN Melissa Duckett, RN, CCRN 11E Medical Surgical 11E Medical Surgical 11 E Medical Surgical 11 E Medical Surgical 11 E Medical Surgical 11E Medical Surgical 11W Cardiovascular Nursing CCRN CCRN Alicia Caro, RN, BSN, RNC Neonatal ICU

6 Poll Question Best Practices for Increasing Staff Engagement in Professional Organizations 12% 24% 31% 8% 25% Pair those who are interested in joining an organization with a current member so that they can attend a meeting together Highlight nurses who are members of professional organizations during Nurses Week Increase the number of professional organizations meeting at NMH Include a list of all professional organizations in enursingnow with contact information for current NMH members Encourage individual units or areas to celebrate when staff join professional organizations