Transcript Magnet Designation - Radford University

 Highest
recognition of a health
care organization’s attainment of
excellence
 A seal of approval for quality
nursing care
 Recognition of facilities that
uphold the tradition of
professional nursing practice
Established by ANCC in 1993
 A culture supporting professional
practice
 Currently 378 Magnet Designated
Hospitals – approximately 6% of
US hospitals
 16 Virginia hospitals with
Magnet designation
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Bon Secours Memorial Regional - 2009
Bon Secours St. Mary’s Hospital - 2008
Carilion Roanoke Memorial-2003
Centra Health Lynchburg General-2005
Centra Health Virginia Baptist – 2005
Inova Fair Oaks - 2009
Inova Fairfax – 1997
Inova Loudoun – 2006
Martha Jefferson – 2006
Martha Washington Hospital - 2009
Montgomery Regional Hospital - 2009
Reston Hospital (HCA) – 2007
Sentara Norfolk General Hospital - 2008
UVA – 2006
VCU – 2006
Winchester Medical Center - 2008
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Greater recognition within the community
for nursing and the hospital
Improved patient care outcomes
Improved nurse-physician relationships
Competitive marketing advantages
Improved recruitment and retention of
nurses, physicians and
other healthcare professionals
Enriched nursing staff
satisfaction
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An opportunity to deploy a group of nurses
to make a change – revisiting current
practices - is change warranted?
Magnet Culture has no fear of failure and
modeled, accepted and absorbed by all
Nursing Strategic Plan = Roadmap with all
levels of nursing contributing
This component focuses on the CNO –
someone who is capable of
transforming the nurses
and the culture
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Nurses are guided, mentored, coached, and
educated - consensus decision used
Showcase your nurses to promote their
image
Shared decision in the workplace – shared
governance, unit based decision, task forces,
interdisciplinary teams
Shared decision making in the profession –
professional associations, presenting and
publishing, competency and certification
Partnerships with schools of nursing
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Nurse in the model = RN
Use ANA Principles of Nurse Staffing - the
ANCC does not say you have to use selfscheduling but it is an excellent way to
demonstrate collaboration
Staffing and scheduling process must
consider acuity, patient population needs as
well as variations in patient population
Expectations in this component include –
interdisciplinary care, accountability,
competence and autonomy
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Resources for nurses in this component
include ANA Code of Ethics for Nurses,
ANA Bill of Rights for Nurses and
safeguarding privacy, security and
confidentiality
Nurse sensitive indicators, patient
satisfaction and nurse satisfaction
at or above national benchmark
Must be able to differentiate
between Professional Practice
Model and Care Delivery System
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More heavily weighted for Magnet facilities
seeking redesignation especially innovation
Quality Improvement
Evidence Based Nursing – using the latest
EBP to guide changes
Research – systematic search for knowledge
about important nursing issues
Nursing Research is aligned with the
mission, vision and values; fits with the
strategic plan, and will provide value to the
facility
Research and Magnet Model
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Research must be integrated into clinical and
operational processes
Nurses are educated about EBP and research
and support human subjects rights
Published research is systematically evaluated
and used by nurses at all levels
Nurses serve on the IRB - review and vote on
nursing research proposals
Knowledge gained through research is
disseminated to the nurses
Resources in place to support
the advancement of EBP and
research in all clinical settings
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Nursing research studies from the past 2
years, ongoing and completed are outlined
in a table which includes
 study title
 study status
 principal investigators (PI) name(s)
 PI credentials
 role(s) of nurses in the study
 study scope (internal to a single
organization, multiple organizations
within a system, independent
organizations collaboratively)
 study type – replication – yes or no;
qualitative, quantitative or both
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Document one completed research study
and describe
*purpose and background
*how the work was done (methods or
approach)
*discuss who was involved
*what units participated
*measurement used to evaluate the
outcomes and the impact
The organization must disseminate
knowledge generated through nursing
research to internal and external audiences
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Quality outcomes related to nursing
Clinical practice related to patient care
Dynamic and define areas of improved
performance as well as additional efforts
needed to achieve improvement
Most are graphically depicted
19 outcomes throughout the
other 4 components
Nursing Research Council leads EBP
and Research Initiatives
 RU partnership provides credibility
and expertise
 A growing culture of excellence and
innovation
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EBP five-step Model:
Uncertainty
to an answerable question
Retrieval of best evidence available
Critical appraisal of evidence for
validity and applicability
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Application of results in practice
Evaluation of performance
Gaining comfort with uncertainty
 Moving clinical problems to
searchable/answerable questions
 PICOT format
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Music Therapy in Surgical Services
Skin to Skin Contact in
Obstetrics
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Bedside Reporting
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Conflict Engagement
Implementing Bedside Reporting: Enhancing Patient Safety
n
Pamela Lindsey MSN RN; Melissa Aaron BSN, RN
Margaret Crigger RN ONC; Kenneth Perkins BSN RN ONC
Introduction
Patients in hospitals today are more
informed and more involved in their
care than in the past. With the
advancement of technology, patients
are living longer and have more
opportunities to participate in their care.
There is evidence that active patient
participation in care produces better
health outcomes. Bedside nurse shift
report is a process where nurses
provide shift-to shift report at the
patient’s bedside. Bedside reporting
allows the patient access to his or her
immediate care and health information
and promotes patient ease of mind
leading to a speedier recovery. Bedside
reporting also assists nurses in
prioritizing patient care and managing
their patient load effectively, therefore,
providing patient-centered care and
enhancing patient safety.
Background
Standard
• Verbal reporting between
nurses at the nurses’ station
• No staff involvement with
patient
Patent
Centered Care
AIDIET
Format
Communication
• A standardized shift report is
utilized during report
• Lengthy report, including
irrelevant information that
fails to address the needs of
the patient
Results
Methodology
SBAR
Format
• Bedside Report-Required method for
nurses providing a hand-off report
• Patient and/or family involved in planning
care
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A- Acknowledge patient
I- Introduce yourself and manage up
D- Duration
E- Explain
T- Thank you
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S-Situation
B-Background
A-Assessment
R- Recommendation
1= Nurse satisfaction scores from pre
and post survey
2= HCAHPS Survey score pre and post
implementation
3= Patient call back survey pre and
post implementation
Bedside Reporting
98%
95%
98%
78%
55%
Key
Components
98%
• Trace all lines and tubing from the point of
origin to site or collection device
1
2
Pre Intervention
Handoff
• The patient/family is seldom
involved in the process with
no formal means to
communicate needs and
concerns
• Does not incorporate
patient-centered care
Report
Format
Time
constraints
• Patient name, diagnosis, and procedure
since admission
• Changes in patient’s condition or episodic
event
• Individualized report takes about 3-5
minutes
3
Post intervention
Bibliography
Anderson, C.,Mangino, R. (2006). Nurse Shift Report: Who Says You Can’t Talk in
Front of the Patient? Lippincottt Williams and Wilkins, Inc. Nurse Admin Q. Vol. 3
pp.112-122.
Hemant K Kassean and Zaheda B Jagoo (2005). Managing change in the nursing
handover from traditional to bedside handover – a case study from Mauritius BMC
Nurs.;4: 1. Published online 2005 January 28. doi: 10.1186/1472-6955-4-1
PMCID: PMC548693
Kim Alvarado, Ruth Lee, Emily Christoffersen, Nancy Fram, Sheryl Boblin, Nancy
Poole, Janie Lucas and Shirley Forsyth. (2006). Transfer of Accountability:
Transforming Shift Handover to Enhance Patient Safety Healthcare
Quarterly, 9(Sp) 75-79
IRB consolidation/mentoring
 Research consortium
 Dress Study
 MRSA Guidelines
 Wound Staging
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Continuing Education Opportunities
 Local
 Regional
 National
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ICU Quiet Times
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Dedicated Education Unit
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Care Delivery Models
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Hypothermia approaches in the ED
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Bedside reporting-validation study
“Improved statistics
would tell us more
of the relative value
of particular
operations and
modes of
treatment… and the
truth thus
ascertained would
enable us to save
life and suffering.”
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Application Manual, Magnet
Recognition Program (2008)
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Aravind, M. & Chung, K. (2009)
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Fineout-Overholt, E. &Johnston, L.
(2005)