Magnet Readiness in the Operating Room

Transcription

1 Magnet Readiness in the Operating Room Samantha K. Madonis, RN, MSN, CNOR Wakana Litwinczuk, RN, BSN, CNOR Michelle Robison, RN, MSN, CNOR Surgical Services UCLA Santa Monica Hospital Disclosure Samantha K. Madonis and Wakana Litwinczuk: No financial interests to disclose 1

2 Clinical Issue UCLA Santa Monica Hospital is currently on the journey to Magnet status. The practice issue we addressed was the difficulty, as a specialty unit, to relate to ANCC s Magnet Recognition Program, resulting in a low rate of Magnet familiarity amongst staff. Magnet surveyors will be asking staff about how their unit is contributing to Magnet practices and goals. Definition of Terms Magnet Recognition Program The American Nurse Credentialing Center (ANCC) developed Magnet Hospital Recognition Program for excellence in nursing services starting in This is the highest national program that recognizes health care organizations that demonstrated nursing excellence. Association of perioperative Nursing (AORN) Nationally-recognized organization that is the fount of knowledge for surgical nursing specialty, including evidence-based practice standards of care and professional education. Certified Nurse of the Operating Room (CNOR) The accredited credentialing program for perioperative registered nurses and gold standard for validating their specialized surgical knowledge and skills. CNOR nurses are committed to proving the highest quality (EBP) care to their patients. Current Practice Specialty nursing units, as the Operating Room, have unique patient populations and nursing practices that differ greatly from other units in the hospital. Several OR staff members sit on Magnet councils (TL, SE, NK, EPP) to learn more and disseminate knowledge to colleagues. An initial Magnet Questionnaire survey was conducted in December 2013, with results indicating that OR staff had a low rate of familiarity to the Magnet Recognition Program. 2

3 Significance of Problem The Magnet Recognition Program reflects all units of the hospital Specialty units have unique patient populations and nursing standards of care Staff must be prepared for Magnet surveyors to be able to discuss their unit s exemplars that reflect Magnet goals and standards Purpose Provide several educational in-services regarding the Magnet Journey, Councils, current unit practices that adhere to Magnet goals and standards, and how the surgical specialty is preparing for Magnet Increase Staff RN knowledge of the Magnet Recognition Program by relating our specialty practices to Magnet benchmarks. Decrease anxiety related to preparing for Magnet surveyors. Performance Improvement Question Does rigorous promotion and education regarding the Magnet Journey help to engage and prepare OR staff for Magnet? 3

4 What Does the Evidence Tell Us Pursuing Magnet Designation (Tinkham, 2013) Magnet designation remains a valid marker of excellence in nursing care, thereby supporting the association between competence and quality nursing care. Our leaders value education and use a clinical ladder system that provides staff members with a framework for receiving professional recognition and financial benefits for attaining advanced degrees, continuing education credit, and certification. Structural empowerment encourages teamwork among all caregivers and with patients by encouraging staff member involvement and accountability. By valuing professional growth of staff nurses and nurse leaders, caregivers become better educated regarding current EBP and can increase patient safety through more appropriate care. Initial Magnet Questionnaire Outcomes 4

5 Results of RN Survey (courtesy of NRE s Vahe Grigoryan) 67% 33% 53% 47% 80% 20% 36% 64% 20% 80% 27% 80% 20% 53% 47% 73% 7% 21% 93% 79% Outcomes Measured Improved Magnet knowledge-base We are continuing our education series on Magnet, then administer a post-test Increase in CNOR Certification We increased our rate by (projected) more than double our current certification rate Interventions October At the 2013 National Magnet Conference, we had an open discussion with CCI regarding group discount program (five or more CNOR applicants), with free study material, and a free re-take of the exam if needed. December Magnet Orientation PowerPoint highlighting the importance of nurse certification. February Live and interactive Webinar with CCI highlighting the importance of nurse certification, promotion of CCI s group discount program (free exam re-take if needed to help reduce testing anxiety!); Collaboration with the UCLA Department of Nursing Research and Education to allow a CNOR Prep-Class to be part of the Dare to be Certified reimbursement campaign. March Promotion of the UCLA Santa Monica Employee scholarship award and Certified Nurse Day discounts on additional CNOR study materials; another Magnet in the OR presentation. 5

6 Interventions cont. : Relating Magnet to the OR Specialty Magnet in the OR Examples of Exemplary Professional Practice and Empirical Quality of Outcomes in the OR: Perioperative nurses effect on the condition of the patients skin (prep solution, positioning, dressings, type of tape, cleaning and checking skin at end of case) (Jurkovich, 2010) Magnet in the OR Examples of New Knowledge, Innovations, and Improvements and Empirical Quality of Outcomes in the OR: Health care associated infections, specifically surgical site infections (SCIP) (Jurkovich, 2010) 6

7 Magnet in the OR Examples of Structural Empowerment, New Knowledge, and Empirical Quality of Outcome in the OR: counts, Timeouts, and hand hygiene Examples of Transformational Leadership is using tools that monitor the initiatives in addition to other data elements within the Perioperative environment that affect compliance with standards. (Jurkovich, 2010) Transformational Leadership (TL) in the OR Quality of Nursing Leadership (Force #1) Management Style (Force #3) Give input to nursing leaders regarding quality of the work environment Follow visionary plans Give input regarding direct care changes for safe and reliable care Initiate practice changes as needed (Battie, 2009) Structural Empowerment in the OR Organizational Structure (Force #2) Personnel Policies and Programs (Force #4) Community and the Healthcare Organization (Force #10) Image of Nursing (Force #12) Professional Development (Force #14) Participation in a shared governance Exemplify Perioperative nursing in everyday life Join AORN Continue Education Provide input on capital equipment (AN I) (Battie, 2009) 7

8 Exemplary Professional Practice (EPP) in the OR Professional Models of Care (Force #5) Consultation and Resources (Force #8) Autonomy (Force #9) Nurses as Teachers (Force #11) Interdisciplinary Relationships (Force #13) Precept and mentor Employ Perioperative educators and CNS s Educate your patients Educate coworkers in your specialty Address patient care issues Become a CNOR Challenge this is the way we ve always done it Treat other members of the team with respect (Battie, 2009) References American Nurses Credentialing Center (ANCC). (2014). American Nurses Credentialing Center Magnet Recognition Program. Retrieved March 21, 2014, from Association of perioperative Nurses (AORN) and Conner, Ramona. Perioperative Standards and Recommended Practices 2014 Edition. Denver, Colorado: AORN, Inc. Battie, R., (2009). PNDS dashboard helps showcase magnet accomplishments. Association of perioperative Nursing Journal, 90(2), Jurkovich, P., Karpiuk, K., and King, C., (2010). Magnet recognition: Example of perioperative excellence. Association of perioperative Nursing Journal, 91( 2), Tinkham, M. (2013). Pursuing Magnet Designation: The Role of Structural Empowerment. Association of perioperative Nursing Journal, 97(2), Barriers/Limitations Language that does not apply to operating room nurses Time! Competencies, educational requirements Lack of full-time Surgical Educator 8

9 Conclusions Specialty units, as the Operating Room, contribute to the success of the Magnet application by demonstrating innovation and EBP in nursing practice. Future Plans As the hospital continues on the Magnet Journey, we plan on giving a post-test Magnet Questionnaire to measure the change of knowledge base amongst RN staff. This will also help us identify where we need improvement in OR-friendly Magnet education and readiness. Acknowledgements We would like to give special thanks to UCLA Santa Monica s CNO, Dr. Edith Matesic, RN, MS, DNP, NEA- BC; Dr. Norma McNair, Dr. Ginny Erickson, Dr. Theresa Haley, and Vahe Grigoyan of NRE for all of their support and expertise. Many thanks to Debbie Miller and Vicki Landry for supporting the project. We would also like to thank Competency and Credentialing Institute (CCI) for their continued support over the next year with our (current) nine more nurses on the path to certification! 9

10 Questions and Comments Thank you 10