Transcript Nursing Clinical Ladder

LOYOLA
UNIVERSITY
HEALTH SYSTEM
Loyola University Chicago
Nursing Clinical Ladder
Clinical
Practice
Professional
Development
Evidence
Based
Practice
Leadership
Professional
Identity
LOYOLA
UNIVERSITY
HEALTH SYSTEM
Loyola University Chicago
Opportunity Statement
LUHS’s need to attract, develop and retain experienced,
expert RNs in direct patient care positions has increased
because of the following:
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Decreased patient length of stay
Increasing patient acuity
Impending nursing shortage
Availability of non-patient care roles for RNs
Project Goals:
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To attract and retain nurses to direct patient care positions
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To implement a clinical ladder program with at least 25%
eligible RN’s participating at levels 3 & 4
LOYOLA
UNIVERSITY
HEALTH SYSTEM
Loyola University Chicago
Reasons Why RNs Leave Direct
Patient Care
Focus groups of LUHS staff nurses identified
the following reasons:
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Lack of recognition for professional expertise
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Desire to develop and broaden knowledge and skills
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Limited promotion availability
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Limited salary range
LOYOLA
UNIVERSITY
HEALTH SYSTEM
Loyola University Chicago
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Solutions Implemented by the
Oversight Committee
Completed literature review
Interviewed UHC
Members with Clinical
Ladder Experience
Agreed upon Benner’s
“novice to expert” model
Developed program
guidelines
Gained approval from
LUHS Sr. Administration
for clinical ladder salary
structure
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Solicited internal feedback
Finalized, implemented
and copyrighted Clinical
Ladder program
Implemented system-wide
education plan
» Video & Binder
» Open Forums
» Program on Intranet
Organized annual pinning
ceremony for level 3 & 4
RNs
LOYOLA
UNIVERSITY
HEALTH SYSTEM
Loyola University Chicago
Solutions Implemented:
Criteria Committee
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Assembled staff RNs to
develop practice specific
criteria
»
»
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»
»
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Ambulatory
Homecare & Hospice
Inpatient
OR/PAR
Specialty
Developed application process
Review Committee
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Developed review process
Reviewed applications and
made leveling
recommendations to Chief
Nurse Executive
Recommended program
revisions based on feedback
Maintain ongoing review
LOYOLA
UNIVERSITY
HEALTH SYSTEM
Loyola University Chicago
Domains of Nursing Practice included
in the Clinical Ladder
Clinical Competence
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Nursing Process
Clinical Competence
Management of the
Continuum of Care
Leadership
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Delegation
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Collaboration
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Management of
Environment
Professional Development
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Mentor
Knowledge Seeker
Quality/Evidence Based
Practice
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Quality Improvement
Professional Identity
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Professionalism
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Communication
LOYOLA
UNIVERSITY
HEALTH SYSTEM
Implementation of the Clinical Ladder is a
contributing factor to LUHS’s declining
nursing turnover rates
Loyola University Chicago
25
20
14.6
15
17.2
16.7
13.1
14.0
11.7
18.95
16.3
10.5
5
0
FY 01
Regional
National
10
FY 00
LUHS
FY 02
LOYOLA
UNIVERSITY
HEALTH SYSTEM
Loyola University Chicago
16% of eligible RNs are participating in
the Clinical Ladder at Levels 3 & 4
Ambulatory
Homecare
Inpatient
OR/PAR
Specialty
118
2
6
9
9
Clinical Ladder RNs participated in greater than 2300 hours of CEU’s
in the past 12 months; 57 RNs function in clinical liaison roles to
enhance quality of care
LOYOLA
UNIVERSITY
HEALTH SYSTEM
Loyola University Chicago
Next Steps:
Staff RN Opportunities
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Involve Level 3 & 4 RNs in nursing practice forums and
practice standards development
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Involve Review Committee staff nurses in program
promotion and education
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Revise criteria as needed based on staff RN and Manager
feedback
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Provide opportunities to educate RNs on Clinical Ladder
program to achieve goal of at least 25% participation
LOYOLA
UNIVERSITY
HEALTH SYSTEM
Loyola University Chicago
Next Steps:
Program Evaluation
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Correlate Nurse sensitive quality indicators with
distribution of Level 3 & 4 RNs
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Compare Employee opinion survey – Nurse Profile - pre &
post implementation
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Qualitative analysis of patient care RN exit interviews
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Publish or present results
LOYOLA
UNIVERSITY
HEALTH SYSTEM
Loyola University Chicago
Thank You to our Teams:
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Program Sponsor: Paula Hindle
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LUHS Sr. Administration for their support of this
program
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The Over 50 RNs who participated in creating our
Clinical Ladder Program
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Oversight Committee: Paula Hindle, Chair
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Criteria Committees: Sandy Swanson, Chair
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Review Committee: Diane Deacy & Sue Flores,
Co-Chairs