Transition to Practice: The Facts. Thinking of being a Clinical Host?

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1 Transition to Practice: The Facts Thinking of being a Clinical Host? A Transition to Practice Program New Graduate RN Participant, 2011 Clinical Host, 2011 is offered to fully qualified new graduate RNs I want to say that I would NEVER have been hired in my current position without the help of the program. No way. The skills, experience, confidence and mentoring this program gave me were invaluable. Thank you. takes place over weeks (depending on curriculum design) includes 24 hours per week of direct clinical experience, conducted under supervision on site at a Clinical Host (i.e, Long Term Care facility) features 8 hours of classroom time every other week, with academic supervision and simulated learning convened by a partnering Academic Host serves as an excellent opportunity to transition a potential new employee into the employment setting, thus facilitating the fast tracking of on-boarding when hired These programs were established through the California Institute for Nursing &Health Care (CINHC) in 2010, and to date nearly 900 new graduate RNs across California have been prepared to provide care in acute and community-based settings in clinics, schools, home health settings and hospice. This will be the first such program specifically focused on long-term care. Enthusiastic Clinical Hosts are fundamental to the program s success. During this pilot stage we welcome your input and creativity in order to develop a meaningful, effective program to prepare new graduate RNs for careers in long-term care. As a Clinical Host, your role includes: Providing the participant with varied clinical learning experiences for up to 24 hours per week Providing an experienced RN staff member to serve as preceptor to supervise the participant Enrolling the RN preceptor in a short training session (up to 5 hours) Paying the program fee (total $4,000 per student participant) CINHC provides all tools, training, support and management for the program, including curriculum, partnership with an academic institution, recruitment of participants, preceptor training, and evaluation tools. These programs are hugely beneficial, and their time has come Nurses do one of the most important jobs on the planet and must have a top rate education. I think your work has charted a new course for nurses all over the world. There s no turning back! - Clinical Host, 2011

2 Clinical Host FAQs Clinical Host FAQs 1. How much does the Clinical Host have to pay for the program? $4,000 per participant. Most of this fee reimburses the nursing school (Academic Host), which covers faculty time, as well as insurance coverage. A portion is retained by CINHC for providing for overseeing the program and conducting the evaluation. $1,000 is presented to the student as a stipend, upon completion of the program. 2. Who picks the participants? You! CINHC will screen all applicants to ensure they meet basic requirements, but individual participants will be interviewed and selected by the Clinical Hosts. 3. Who builds the curriculum? The curriculum will be created by a statewide Advisory Board representing leaders in nursing education and LTC*, so that the course is built specifically for RNs entering into a LTC setting, and will fill the gaps between education and practice. * Clinical Hosts who join early will be invited to participate in curriculum design. 4. Who is responsible for liability insurance, workers compensation, etc.? The new graduate RN participants are enrolled in the program through the partnering nursing school, so are covered under the insurance program of the Academic Hosts. Your exposure would be the same as it would be for any student nurse participating in a practicum on your premises. 5. What are the obligations to the participant after the program? Clinical Hosts should be willing to provide references for their participant. We ask that all Clinical Hosts have a capacity and intention to hire, however there is no obligation to hire the participant following the completion of the program. If it is not the right fit, then the placement ends once the program is completed. The participant will have gained valuable experience in the field, so it is still worthwhile! 6. What are the preceptor qualifications? We ask Clinical Hosts to put forward experienced RNs, who have an aptitude and desire to serve in a teaching or role model capacity. We provide training and support throughout the program, including site visits from faculty, and regular check-ins to address any questions that may arise. 7. What does preceptor training entail? We estimate up to 5 hours for the training. We prefer that all training be conducted at the Academic Host location because of the value of group interaction, but we can make arrangement for remote learning if needed. 8. Can we have more than one preceptor per participant? We usually advise a one-to-one relationship between participant and preceptor, though in some cases, with careful planning, a multiple preceptor assignment can work. 9. Are the participants able to do assessments? Unlike some student residencies, all participants are licensed RNs, so once oriented, they are able to perform activities appropriate for an RN at your facility. This would, of course, be done while supervised by the preceptor. 10. What happens if the student does not complete? We hope this won t happen, however, if it is early in the program, the placement can be filled by another qualified candidate. If not, a refund may be considered. 11. Can we host more than one student participant? Yes! The same fee of $4,000 per student will apply, but Clinical Hosts may provide multiple RN preceptors and hold multiple placements.

3 Components of New Graduate RN Transition to Practice Programs ASSESSMENT Initial Learning Assessment Program participants complete a four to eight hour critical thinking and skills competency evaluation including: Physical assessment Sterile technique Medication administration Medication math evaluation IV skills Foley catheter insertion Survey Instruments for Participants Program participants complete this assessment tool at program start and completion: Casey-Fink Graduate Nurse Experience Survey (revised) Program participants complete an evaluation at end of program. Survey Instruments for Participants and Preceptors Program preceptors work with participants at program start and completion to complete the competency assessment tool and on individual competency-specific learning tools adapted from the six QSEN competencies: Teamwork and Collaboration Patient Centered Care Pain Management Safety: Medication Administration Quality Improvement Informatics LEARNING PLAN PRECEPTED CLINICAL HOURS DIDACTIC Faculty Assignment Faculty members are matched with a group of participants Online Posting or Distribution Course curriculum Course calendar Clinical site-specific information Competency assessment tools Faculty/Participant Meetings Faculty members conduct a 1:1 meeting with each participant to identify strengths and learning opportunities Faculty members conduct initial meeting with entire participant cohort to establish meeting schedule, milestones, and communication preferences Clinical Site Placement hours/week for a total of weeks depending on program Preceptor Assignment Preceptor receives information packet, training and/or orientation Clinical Rotation Begins Site-specific orientation and on-boarding activities Preceptor reviews site-specific competency check-off with participant Preceptor/participant collaboratively develop plan of action to meet competency expectations Preceptor/participant collaboratively develop plan of action for communication, and documentation of goals and accomplishments New Graduate RN Transition to Practice Program Synopsis Classroom Education Cohort meets regularly scheduled during course of program for: Classroom education Simulation experiences Scheduled and /or open skills labs (regularly scheduled and/or open ) Sample Curriculum Topics Kick-Off/Welcome Meeting Patient- and Family-Centered Care Wound care management Quality and safety Medication safety Evidence-based practice Pain management Collegial communication Informatics IV PICC line Final project presentations by participants Certificate of completion ceremony program Beginning in late 2009, New Graduate RN Transition to Practice programs were established to assist newly graduated and licensed RNs by increasing their confidence and competence, thus increasing their employability. Structured to provide classroom and clinical-based experiences, programs were housed in schools of nursing in partnership with hospitals and community-based healthcare agencies, without the clinical sites obligation to hire. Though independently organized, each program was based on common concepts and central components, designed to develop a shared recognition of the benefits and skills obtained. RN participants were not paid, but did earn academic credit and an industry recognized certificate of completion. Roles and Responsibilities Tracking Instrument for Program Coordinators Employment Tracking Log tracks participants who are hired into RN positions Survey Instrument for First Employers Direct supervisors of newly hired participants are asked to complete this assessment tool at three months post-hire: First employer assessment survey For more information, visit Program Sponsors Academic: Academic program collaborates with service partner to identify funding, manage budget, develop participant selection criteria and develop curriculum. Program offered as an academic course that includes malpractice and workers compensation insurance, program coordination, and access to simulation and skills labs. Service: Clinical site liaison collaborates with academic partner to manage funding and budget issues, participant selection, curriculum development, preceptor training and program oversight. Program Coordinator Typically employed by academic sponsor. Responsibilities include: Recruiting and selecting of applicants in conjunction with clinical partners Facilitation of communication among service partners, preceptors, participants and faculty Leading curriculum design in coordination with service and academic partners Ensuring contracts are in place with clinical partners Assigning participants to preceptors, based on fit and availability Functioning as a preceptor liaison Ensuring participants have cleared pre-clinical requirements Identifying faculty Developing program calendar and securing space for classroom and simulation work Establishing systems to track course work and final project Setting expectations regarding assessment plan and distributing surveys at designated times Maintaining employment tracking log Distributing certificate of completion at end of program, and distributing stipends, if available Clinical Faculty Employed by academic sponsor; responsibilities vary by programing, and may include: Collaborating to develop curriculum Assisting with initial assessment Leading skills simulation lab session Lecturing at didactic sessions Working with a cohort of participants throughout the program Clinical Preceptor Employed by service partner; responsibilities include: Precepting participants throughout clinical experience Completing pre- and post- QSEN-based assessment tools Completing the competencyspecific QSEN-based teaching tools during the course of the preceptorship

4 Sample MOU between Clinical Host and California Institute for Nursing & Health Care MM/DD/YYYY Long Term Care Transition to Practice Program Clinical Host Street Address City, CA, Zip This agreement is between the California Institute for Nursing & Health Care (CINHC), th Street, Suite 300, Oakland, CA and XXX, LTC, Street, City, CA zip. The scope of this agreement shall apply to CINHC and XXX. SERVICES: CINHC will provide a Transition to Practice Program (Program), or residency, for newly graduated and licensed Registered Nurses. The Program develops nursing skills specifically to promote health and wellbeing in long-term care settings, memory care, and overall care for the aging. The Transition to Practice Program improves the competence, skills, and confidence of new graduate RNs, and provides a means to recruit and mentor well-prepared RNs in a cost-effective manner. The Program is seen as a strategy to increase the number of committed healthcare professionals seeking careers in long-term care as the needs and acuity of patients in long-term care facilities increases. The week Program will be provided through YY academic institution in partnership with CINHC, with various Clinical Hosts providing clinical experiences to program participants. YY will provide for professional liability and worker s compensation insurance, will offer the academic portion of the Program, which includes faculty to monitor and support the clinical/precepted components. PAYMENT TERMS: The fee is $4,000 per program participant. 100% of the program fee will be due upon signing the contract. Checks should be made out to the California Institute for Nursing & Health Care. DATES: The signed contract is due within 10 working days of the mailing date on the contract in order to secure a slot and the stated fee. CINHC RESPONSIBILITES: Screen all applicants to ensure they meet basic requirements Provide five (5) hours preceptor training Provide all tools, training, support and management for the program, including curriculum, partnership with an academic institution, and recruitment of participants Provide a standard certificate of completion, used by Transition to Practice Programs across California Provide Evaluation tools Collect, analyze, and centrally store all data collected from the evaluation to assess the impact of the Program XXX, LTC RESPONSIBILITIES: Page 1 of 2

5 Provide a staff member or preceptor to supervise the participant(s). We recommend a one-toone preceptor-participant relationship. Permit preceptor to enroll in a short training session, up to five (5) hours Provide the participant(s) with varied clinical learning experiences for 24 hours per week, for weeks Pay the Program fee, which includes a participant stipend Interview and select individual participant(s) for the Program Provide references for participant(s) As possible, hire participant(s) upon Program completion, based upon fit within the organization and vacancy Participate in the surveys distributed as part of the Program evaluation TERM: The term of this agreement shall commence on X/X/XXX and terminate on X/X/XXX. CANCELLATION: Either party may cancel this agreement at any time, with or without cause, for any reasons or for no reason, upon 30 days prior notice, by written notice from one party to the other without liability. Please contact me at (510) , if you have any questions. Sincerely, Bob Patterson, RN, MSN Administrative Director California Institute for Nursing & Health Care P.O. Box Oakland, CA Agreement to the Terms and Conditions provide by the California Institute for Nursing & Health Care to XX, LTC for the provision of providing the Transition to Practice Program to XXX, LTC. Deloras Jones, Executive Director Date Name, Title Date Tax ID: Page 2 of 2

6 Memorandum of Understanding between and This Memorandum of Understanding ("MOU") is entered into this day of 2012 by and between the ("University") and ( Agency") 1. University has an approved and accredited nursing program (the "School of Nursing" or "Nursing Program") which requires the use of clinical facilities so that its students may obtain clinical nursing experience (the "learning experience"). Agency has suitable clinical facilities for furnishing the learning experience. It is for the mutual benefit of the parties that student(s) in the Nursing Program use Agency facilities for the learning experience. 2. The learning experience shall be under a preceptorship whereby the School of Nursing provides the student(s), and Agency provides the facilities. 3. University and Agency coordinate planning of the learning experience. 4. Agency shall provide an environment which is appropriate for the learning experience and meets the written objectives of the Nursing Program as provided by University. Agency shall provide an orientation to School of Nursing faculty and students which includes Agency expectations regarding student affiliation, Agency policies and procedures which impact patient/client care, and general information which assists in the socialization of student(s) and School of Nursing faculty with Agency. 5. Agency shall designate, after consultation with the School of Nursing, a preceptor for student(s) ("Preceptor"). Faculty, with input from Preceptor, shall evaluate the performance of student(s) according to guidelines outlined by the School of Nursing. 6. The University shall coordinate with Agency, and monitor, all instruction University provides to School of Nursing student(s) at Agency. The Associate Dean for Academic Programs in the School of Nursing and/or a designated faculty member shall be available for conference or assistance as needed by Agency during the learning experience. 7. Schedules and student assignments shall be developed so as to enhance the goals of the nursing program and complement the primary mission of Agency. The University and Agency shall perform an annual review to determine the effectiveness of this MOU. 8. University shall be responsible for the academic activities of student(s), as well as any necessary disciplinary action, during the learning experience. While at Agency facility, student(s) shall be subject to Agency s rules, regulations, and confidentiality standards. Student(s) shall not be considered employees of Agency. Student(s) may be removed from the learning experience at Agency either by the University, or at the request of Agency following consultation with University. 9. Agency shall have ultimate responsibility for patient/client care and services, and shall maintain its staff in adequate number and quality so as to ensure the safe, continuous services it provides. 10. Agency acknowledges that student educational records are protected by the Family Educational Rights and Privacy Act ("FERPA"), and that generally student permission must be obtained before releasing specific student data to anyone other than University. University agrees to provide Agency with guidance with regard to compliance with FERPA. 11. University and Agency agree not to discriminate in employment, academic programs, or the provision of services on the basis of race, color, religion, ancestry, national origin, age (over 40 years), sex, sexual orientation, marital status, medical condition, disability or any other basis protected by federal, state, or local ordinance or regulation.

7 12. University shall provide Worker s Compensation Insurance and Professional Liability coverage for student(s) while student(s) is(are) participating in the learning experience at Agency. Evidence of such coverage shall be furnished upon request by Agency. In addition, Agency shall furnish University s proof of Worker s Compensation Insurance and Professional Liability coverage. 13. University and Agency agree to defend, indemnify and hold one another, their respective officers, employees, students and agents harmless from and against all liability, loss, expense (including reasonable attorney s fees), or claims for injury or damages arising out of the performance of this Agreement but only in proportion to and to the extent such liability, loss, expense, attorney s fees, or claims for injury or damages are caused by or result from negligent or intentional acts or omissions of the indemnifying party, its officers, employees, students or agents. 14. The services under this MOU are to be performed by and between independent contractors, these being the University and Agency. 15. The term of this MOU shall commence on and shall be automatically renewed for succeeding terms of two years each. This MOU may be terminated without cause by either party upon giving the other party sixty (60) days written notice; provided, however, that any such termination by Agency shall not be effective as to any student who at the date of mailing of notice by Agency was participating in the learning experience at Agency until the student has completed the learning experience for the then current academic term (semester), except at the election of University. 16. This MOU shall be construed in accordance with the laws of the state of California, and shall be subject to the rules and regulations of the Board of Registered Nursing of California. IN WITNESS WHEREOF, this MOU has been executed in duplicate by and on behalf of the parties hereto, on the day and year first above written UNIVERSITY SIGNATURES: NAME TITLE SIGNATURE ADDRESS PHONE NUMBER AGENCY Agency: Address: Telephone: Fax: Print Name: Signature: Date

8 The MHC and CINHC Nursing Education Initiative The Masonic Homes of California and the California Institute for Nursing & Health Care are partnering to create collaborative models to increase the capacity of the long-term healthcare profession to train and hire more highly qualified nurses, in order to provide better quality of care, and therefore quality of life for older adults and particularly those with cognitive impairment. The California Institute for Nursing & Health Care is a nonprofit organization dedicated to transforming the capacity of nurses to meet the evolving health needs of Californians. The California Institute for Nursing & Health Care (CINHC), the state s nursing workforce center, fulfills a unique role with immense benefits for Californians. CINHC s neutral, convening capacity and coalition-building among government, education, health care employers, foundations, associations, and nurses has contributed to long-term, sustaining solutions for a quality nursing workforce. CINHC has led efforts since 2003 that have had a direct impact on: Nursing infrastructure: the seamless progression from associate to baccalaureate degree; statewide competency standards for new nurses and nursing practice; new graduate transition to practice programs; clinical faculty training; and simulation in basic education and nursing practice. Leadership development and workforce diversity, including recruiting more men and under-represented minorities to nursing. An increased supply of qualified nurses through efforts to increase educational capacity TH STREET, SUITE 300, OAKLAND, CA (510) Deloras Jones, RN, MS Founder and Executive Director, CINHC Deloras is the Founder and Executive Director of CINHC. She was the chief nursing executive for the California Division of Kaiser Permanente. Active in both statewide and national nursing issues, she was the founding chair of California Nursing Outcomes Coalition Database Project. Deloras is a Past President of the Association of California Nurse Leaders and served on the American Organization of Nurse Executives Board. Recently, she led the statewide effort to implement the Institute of Medicine (IOM) Recommendations on the future of nursing in California, helping to establish the California Action Coalition. The Masonic Homes of California is a nonprofit organization working to change the world for the better by providing cutting-edge solutions to the challenges faced by Masons, their families and our society through all of life s major transitions. The Masonic Homes of California (MHC s) strategic priority for 2012 is to improve provision for those who suffer from Alzheimer s and dementia both at its own facilities and in the wider community. While working on this initiative, it quickly became apparent that there was a deficiency in the number of qualified Registered Nurses working in the longterm care profession. It is also apparent that with the right training, RNs can provide the high-level care which is required for a population that often presents a range of varied problems and require help from many different health professionals across the long-term care continuum. In keeping with Goal 4 of the California State Plan for Alzheimer s Disease, (2011) the Masonic Foundation joined forces with CINHC to better prepare new nurses for a career in long term care, developing a multifaceted approach which includes curriculum redesign, a case management program with a focus on memory care, and a new graduate transition to practice program (in collaboration with MHC) MISSION BLVD, UNION CITY, CA (510) Mel Matsumoto, Executive Vice President, MHC Mel has been EVP at MHC since August 2008, overseeing both of MHC s campuses in Union City and Covina, the Masonic Outreach Program and Masonic Youth and Family Services. He has been in the field of aging/senior services for over 30 years, serving in numerous executive and volunteers leadership positions.