Vizient/AACN Nurse Residency Program · Katie Davis, MS -HSM, BSN, RN. Director, Nursing Programs: ... Residency Program • Identify the program components and how they fit into

Vizient/AACN Nurse Residency ProgramTM

Disclosure

The presenters have nothing to disclose:

Vizient Presentation │ February 28, 2018 │ Confidential Information2

Angela Renkema, BSN, RN-BCNRP Programmatic [email protected] Hall, BFASenior Program [email protected] Olson, MSN, MBA, RNSenior Director, Nursing [email protected] Davis, MS-HSM, BSN, RNDirector, Nursing [email protected]

Learner Objectives

• Explain the evidence used to develop the Vizient/AACN Nurse Residency Program

• Identify the program components and how they fit into your organization

• Apply the tools needed to begin a successful Vizient/AACN Nurse Residency Program

Vizient/AACN Nurse Residency Program │ 2019 │ Confidential Information3

AACN = American Association of Colleges of Nursing

Introductions

Vizient and American Association of Colleges of Nursing │ 2019 │ Confidential Information4

First year “Boot Camp” model


Source: https://www.pinterest.com/pin/83598136808771121

Resident’s reflections

“Beyond thrilled to work in a special care nursery. I can’t believe I get to work my dream job as a new grad RN” – A nurse at the beginning of the program

“ At the 6 month point I felt very stressed and overwhelmed. I had recently come off orientation and I didn’t think I would be able to handle all of my tasks. I was questioning if I made the right choice becoming a nurse” – A nurse at 12 months reflecting on her 6 month experience

“Do not get frustrated, stay the course, you will get past the first year of nursing and be so surprised with how far you came and will be looking forward to what is around the corner without even knowing you are doing it . . .” A nurse at 12 months giving advice to the next group of residents


Program history


Program development

2002 NRP begins demonstration project and multisite research study

2008 NRP made available to hospitals nationally outside of University HealthSystem Consortium membership

2010 Institute of Medicine report on the future of nursing

2011 Hawaii adopts NRP and becomes the first to implement a state collaborative

2013 New evaluation tools/dashboardsMaryland adopts NRP and joins as a state collaborative (Maryland Organization of Nurse Executives)

2016 Pennsylvania adopts NRP and joins as a state collaborative (Pennsylvania Action Coalition)Ambulatory materials added to the curriculum

2017Launched NRP mobile survey and automated email remindersContinued growthEnhancements to resident survey process

2019 + Future

Release NRP Administration Tool540 + members



“This report is really about the future of health care in our country. It points out that nurses are going to have a critical role in that future, especially in producing safe, quality care and coverage for all patients in our health care system.Donna E. Shalala, PhD Chair, Committee of the Robert Wood Johnson Foundation Initiative on the Future of NursingInstitute of Medicine

2010 Institute of Medicine report on the future of nursing

Institute of Medicine report

Recommendation 3Implement nurse residency programs. State boards of nursing, accrediting bodies, the federal government and health care organizations should take actions to support nurses’ completion of a transition-to-practice program (nurse residency) after they have completed a prelicensure or advanced practice degree program or when they are transitioning into new clinical practice areas.

Health care organizations that offer nurse residency programs and foundations should evaluate the effectiveness of the residency programs in improving the retention of nurses, expanding competencies, and improving patient outcomes.

Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health. Washington, DC: National Academies Press; 2010. http://www.nationalacademies.org/hmd/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.aspx. Accessed December 20, 2017.


http://www.nationalacademies.org/hmd/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.aspx

Vizient/AACN Nurse Residency Program


ID

MT

WA

OR

SDWY

ME

IANENV UT

CO WVMOKS

AZ NM OKTN NC

VAKY

AR SC

ALMSGA

CA

LA

FL

ND

TX

MN

INIL

WIMI

PAOH

NY

AK

AK & HI not to scale

HI

VTNH

MA

RICT

NJDEMD

DC

Participating

Not participating

Adopted as state model

Organizational impact


Return on investment

• National average turnover for a new graduate nurse is 17.5% (PricewaterhouseCoopers, 2007)

• Average turnover cost per new graduate nurse for an organization $88,000 (Jones, 2008)

• Experienced nursing staff can offer a significant economic benefit to your organization, given the potential financial impact of poor patient outcomes such as falls, hospital- acquired pressure ulcers, and vascular catheter–associated infections

• Seasoned, competent nursing staff also have an impact on publicly reported patient satisfaction scores, including staff responsiveness, nursing communication, and pain management


Retention is a signature outcome of the Vizient/AACN Nurse Residency Program


1 Kovner CT, Brewer CS, Fatehi F, Jun J. What does nurse turnover rate mean and what is the rate? Policy Polit Nurs Pract. 2014;15(3-4):64-71.

Qualitative benefits

Staff engagement• Commitment to the nursing profession – advanced degrees, specialty

certifications, participation in meetings (Rosenfeld, Glassman, & Capobianco 2015)

• Professional culture change

Evidence-based practice• Support to the nursing strategic plan initiatives• Staff engagement in EBP and the ability of it to improve patient

outcomes• EBP projects are highly valued throughout organizations, and have an

impact on improving nursing practice (Goode, Lynn, McElroy, Bednash, & Murray, 2013)


Hospital’s story


Conceptual framework


A transition to competency and professionalism


Program is designed to support the new graduate nurse to:

• Use effective decision-making skills

• Provide clinical nursing leadership at the point of care

• Incorporate research-based evidence into practice

• Strengthen professional commitment to nursing

• Formulate an individual development plan

The year-long journey


High expectations

At 6 months

At 12 months competent practitioner

Source: 1) https://www.pinterest.com/pin/132011832806434969, 2) https://blog.employersolutions.com/keeping-medical-professionals-drug-free/ 3) https://www.goconqr.com/p/5289707-jobs-descriptions-flashcards---flash_card_decks

Conceptual framework


Benner’s From Novice to Expert based on:

Dreyfus’ Model of Skill Acquisition


Benner’s Novice to Expert


• Novice (nursing student)

• Advanced beginner (new graduate nurse)

• Competent (1 to 2 years of practice)

• Proficient (beginning to see the “big picture”)

• Expert (having a grasp of the situation with all of its various possibilities and constraints)

Program implementation


Program model


Evaluationand

benchmarking

Requirementfor an

academicpartnership

Developmentof professional

portfolio or plan

Interactivewith experts

in theorganization

Participationin an

evidence-basedpractice project

Mandatoryparticipation

of newgraduate hires

Curriculumfocus on

professional practice

NRP implementation


• Applied across all practice settings (ambulatory curriculum is now available)

• Recommend 1.0 FTE residency coordinator

• Establishment of an advisory board

• Requires an academic partner

• Vizient/AACN Nurse Residency Program™ curriculum for development of seminars, for application across all program settings

• Development of facilitators and seminar content experts

Roles that support the Vizient/AACN Nurse Residency ProgramTM


Supporting roles


CNO

NRP coordinator

Facilitator

Preceptor

Unit nurse manager

Content expert

Academic partner

HR/ recruiting

Resident

Interactive activity: In your workbook identify which role matches up with the listed responsibilities.


Nurse residency program coordinator


• Nurse with an advanced degree preferred• Teaching experience• Recommend 1.0 FTE• Plans and manages the program• Identifies program faculty and other

resources• Orients all program faculty and nurse

residents• Markets the program internally and

externally


• Develops and maintains the program evaluation plan

• Functions as a liaison with the national components of the program (Vizient/AACN)

• Attends annual Vizient/AACN meeting

• Assures compliance with accreditation standards

Nurse residency program coordinator continued…

Resident role


Communicate Expectations

• Mandatory

• Attends all events

• Accountable for scheduling

• Actively participates in evidence-based project

• Completes all surveys

CNO

Facilitator

PreceptorUnit Nurse Manager

HR/Recruiting

Academic Partner

Content Expert

Resident facilitator role

• Coach, guide and mentor*• Facilitates small group discussion*• Promote life-long learning*• Participate in seminar activities• Support evidence-based project• Provide clinical oversight

*indicates essential components of facilitator role


Resident facilitator


• Clinical nurse specialist• Staff development educator• Advanced practice nurse• Senior clinical nurse• Former resident• Recommend that managers are

not used

Resident facilitator support

• Orientation to the nurse residency program

• Grant access to Vizient website

• Review facilitator resources on Vizient website

• Provide seminar topics, and case studies to supplement clinical reflection time discussion

• Quarterly meetings (at minimum) for facilitator group

• Hold facilitator debrief sessions as necessary

• Provide educational sessions on facilitator focused topics

• Share facilitator evaluations

• Provide resident tracking logs


Facilitator role time allotment


Facilitator responsibility Monthly time allotment

Facilitate small group discussions

45 minutesIf not attending entire seminar

Relationship building and clinical tracking 1-2 hours

EBP project work 1-4 hours

Content expert and class organization 2-4 hours

Seminar attendance 4 hours If requested to attend entire session

Preceptor

Role• Guides and coaches• Facilitates socialization• Communicates evaluation• Reinforces NRP content

Support• Preceptor course• Provide feedback from preceptor evaluations• Preceptor logs and handoff tools


Unit nurse manager role

Role• Facilitates participation• Communicates with the facilitator• Helps resolve scheduling issues• Assigns preceptors• Supports evidence-based projects• Attends celebrations and project presentations

Support• Create 12 month calendar at the beginning of each residency cohort• Share outcome data at manager meetings• Partner with them for program initiatives


CNO/CNE

Role• Champion of the program• Obtains resources

–Budget support–Space–Facilitators

• Manager commitment• Resident commitment• Attends advisory board meetings

Support• Quarterly meetings with coordinator: strength, opportunities, outcomes• Provide time to talk in seminars


Content expert

Role• Shares expertise• May be from outside of organization• May be from outside of nursing• Uses creative approach

Support• Provide the curriculum chapter• Share resident evaluations• Guide them in innovative teaching strategies


Academic partner

Role• May partner with hospital coordinator• Identify faculty and other resources• Market program to students and faculty• Serve on advisory board• Attend annual Vizient/AACN meeting

Support• Provide feedback on nurse residents preparation for professional nursing


Human resources and recruiting

Role• Market Program to schools of nursing• Prepare one page handout for potential applicants• Maintain an NRP website/advertisement on human resources page• Define hiring processes, expectations and interviewing• Assist with applicant data• Assist with retention data• Sit on advisory board

Support• Update with policy changes• Recruit with them/send engaged resident to recruit with them


Researcher role


• Assists with the organization evaluation plan

• Evaluates Vizient reports

• Reviews resident abstracts

• Assists residents in poster development and preparing presentations

• Provide EBP education and support to residents

Advisory board


Establish an advisory board

Purpose: Raises the level of importance of the nurse residency program in the organization and provides oversight for program guidelines and implementation.

• Collaborative approach – involves all areas of the organization• Feedback from stakeholders• Engagement of stakeholders• Creation of policies


Issues to address with the advisory board


Policies regarding attendanceWhat happens when resident is late?What happens when they miss class?

Below benchmark outcomes – Improvement planBelow benchmark in certain outcome, how are you going to improve?

Evaluation planWhich metrics are you tracking? How do you evaluate success of the program?

Resources neededNeed a content expert? Need space for seminars? Need assistance with engagement in the program? Budget issues

Sample advisory board agenda

Introduction/welcome

Program goalsCreation of program goals specific to your institution; review of program goals

Current state of NRPHow many cohorts completed the program? How many cohorts currently in the program? What is the current attendance rate? Review of EBP projects and summary of seminars and evaluations.

Resources and budget

Policy creation/policy reviewCreate or update policies as needed


Sample advisory board agenda continued

Review of NRP outcomes and evaluationLook at Dashboard and highlight outcomes that are linked to goals, or highlight outcomes of importance to your organization. Discuss areas of success and areas of improvement

Accomplishments and celebrationsHighlight a successful EBP, NRP story related to safety of a patient, share positive feedback or a residents’ narrative


Advisory Board: Policies to consider

Attendance• Number of seminars a resident can miss• Tardiness to seminar• Planned life events (weddings)• Make up work required

Hiring practices• Do you hire ADN’s, is going back to school required?• Who is eligible for the Nurse Residency Program?• Do they need to pass their NCLEX first?


Advisory board planning

Interactive activity

• Identify key institution specific members for the advisory board

• Create next advisory board agenda


Program structure


Nurse Residency Program structure

What is it?• The cohort attends seminars together for 4 or more hours monthly• Small groups meet with their facilitators during seminar breakouts for clinical

reflection periods• Content is presented by content experts and case studies or exemplars may be

used to further discussionWhat is required?• Program coordinator• Delegated facilitators to coach small groups of residents• Content experts from the health system to deliver seminar contentWhy?• Provides application level knowledge to help bridge the gap between school

and practice• Provides opportunities for residents to debrief in seminar, more intimate groups,

thus forming a strong support group


Nurse Residency Program structure Cohort group

Small groups Small groups


CoordinatorFacilitator Facilitator

Group structure/sample #1


Cohort #1

Acute care group

Hospital facilitator

Critical care group


Progressive care group


Pediatrics group


O.R. group


O.R. = Operating room



Cohort #2

Trauma/neuro service line

Hospital facilitator Co-facilitator

Cardiovascular service line


Acute and oncology

service line


Pediatrics service line


ED service line

Hospitalfacilitator

Co-facilitator

ED = Emergency department



Cohort #3

Mixed group Critical Care ED Telemetry acute


Mixed group Critical Care ED Telemetry acute

oncology


Mixed group Pediatrics, obstetrics


All units Community hospital


Planning Considerations

• Plan 12 month schedule prior to residents start date• Have seminar on the same day of each month for a cohort• Additional educational opportunities that residents need to participate in• Facilitator and content expert availability


Curriculum


Curriculum and program emphasis


LeadershipQuality outcomes Professional role

Ambulatory

Evidence-based practice project

Curriculum

Leadership Patient care delivery, care coordination, resource management, delegation, inter-professional communication and conflict resolution

Quality outcomesPain management, skin and wound management, fall prevention, medication safety, infection control, patient teaching and management of the changing patient condition

Professional roleEthical decision making, end of life care, cultural competence, stress management, evidence based practice and professional development


• Critical thinking and clinical reasoning

• Patient safety leadership

• Interprofessional communication

• Evidence-based practice

• Patient and family centered care

• Professional progression


Curricular threads: Application is the key

Curriculum structure


• Purpose• Assumptions

• Objectives• Curriculum content

• Seminar implementation examples• References and bibliography

Curriculum application


Adult learning theory

• Self directed learners

• Why should I know something, what are the benefits and what is in it for me?

• Like to apply previous experience

• Engage in solving realistic problems

• Have mutual respect

• Involve in the learning process


Characteristics of advanced beginners

Rule guided• Unable to grasp the big picture

–Concentrates on the rules–Limited critical thinking

Task orientated• Focused on completing tasks rather than focusing on larger plan of

care• Anxiety surrounding loss of control when behind in tasks


Supporting the advanced beginner

Establish role and expectations of the nurse• Need guidance• Scope of practice

Need credible sources of information and teaching• Preceptor and facilitator

Facilitators and preceptors must teach discrimination• Question them• Normal versus abnormal• Trend changes• Relative importance of different aspects of the situation• Recurring themes based on experience


Additional considerations

• Be aware of the diversity among learners

• Consider generational differences

• Provide frequent breaks and the ability to move around

• Change activities every 10-20 minutes

• Encourage reflection on content


Structuring the monthly seminar


• Clinical reflections • Content from one or more of the three

sections – Leadership– Quality outcomes – Professional role

• Case study or clinical narrative• Time for project work (later in the year)

Sample Agenda: Seminar 1

Time Topic08:00-08:15 Welcome and ice breaker08:15-09:00 Introduction to Nurse Residency Program

• Goals• Content• Expectations

09:00-10:15 Stress management• See chapter for implementation ideas

10:15-10:30 Break10:30-11:00 Complete NRP surveys11:00-12:00 Clinical reflection time

• Establish ground rules


Sample agenda: Management of the changing patient condition Time Topic08:00- 09:00 am Clinical reflection time09:00-10:15 am Simulations and debriefings (Rotate stations)

• Respiratory distress• Sepsis management• Full cardiac arrest

10:15am -10:30 am Break10:30-11:30 am Discussion

• Communication during an emergent situation• Chain of command• Family education and support during a code

11:30am-12:00pm Stress management: Coping strategies and self care after a patient death


The focus is application and the development of clinical reasoning!

Sample agenda: Patient safety dayTime Topic

08:00-08:30 am Review of nursing sensitive indicators by hospital and unit

08:30 –09:15 am Safety rounds and audits on residents units. Assess the following• Fall prevention measures• HAPI prevention• CAUTI Prevention• CLABSI prevention

09:15-09:45 Debrief and discussion surrounding findings

09:45-10:00am Break

10:00-11:00am Patient safety stations• Skills practice of central line change• Skills practice in identifying correct interventions for HAPI’s• Locating hospital polices, procedures and clinical practice

guidelines• Skills practice on identified skill by nurse resident group

11:00-12:00pm Clinical reflection time


Lessons learned: content delivery


This is:• Focus on application of concepts• Clinical reasoning

Avoid lecture format – interaction is crucial!

Be creative!

Application ideas

Curriculum application•Escape rooms•Low/high fidelity simulation•Quality and safety rounds•Case studies•Role play•Flip classroom•Concept map•Jeopardy•Price is right

Applications•Poll everywhere•Kahoot•Socrative•GooseChase•Videos – Khan academy/TED talks

•Headspace


Nurse Residency Program website review

• Program implementation

• Curriculum

• Chapter set up

• Case studies


Curriculum development

• Identify seminar objectives• Review curriculum chapter and select areas of focus• Create seminar content

–PowerPoint if needed to supplement knowledge–Application of knowledge activities

Interactive activity: Plan a seminar topic using the curriculum chapter and website resources


Clinical reflections: structure


• Break up into small facilitator-led groups • Opening questions:

– What challenges, opportunities or victories have you had in the last month?

– Are you feeling more comfortable in your role?• Encourage open sharing about developments or

milestones and situations• Give advice and share own experiences when

appropriate• Not a gripe session! It should be problem solving

Clinical reflections: group expectations


• Participation is expected to promote ongoing professional growth• Issues are related to the work environment• For personal issues, refer the resident to an institutional resource for

support• Discuss experiences – both positive and negative

– Get support– Reinforce achievements– Recognize that everyone has similar experiences

Sample ground rules


• Respect for all decisions and ideas put forth during the discussion

• What is said in the session is considered confidential unless it is a safety issue

• There will be no record of who said what during discussion

• Everyone is encouraged to participate in discussion

• Be respectful of others’ time

• Be respectful when others are speaking

• No electronics allowed

Facilitation tips

• Build trust in your small group

• Refer back to ground rules as necessary

• Use opening words that encourage information sharing (describe, explain, tell me)

• Use closed ended questions to clarify between options or to move the discussion along

• Acknowledge feelings, but refocus as necessary

• Use questions that encourage critical thinking–What possible explanations are there?–What else should we consider?


Clinical Reflections


Facilitation case studies

Interactive activity: Review one of the facilitation scenarios. In your small group discuss how you would handle the situation as a facilitator.


Professional development plan and promoting engagement


Professional development

• Discuss professional development throughout seminars–Examples: Content experts sharing career paths Quality and safety topics: encourage joining committees Evidence-based practice project: professional organizations to

submit abstracts too

• Encourage creation of a professional development plan


Professional development template

Include on template:• Professional goals

–1st year–2-3rd year–5 year

• Certification• Council membership

– Internal/external• Growth opportunities on the unit• Advancement of education• Professional nursing organizations and journalsHave resident share plan with nurse manager and/or director


Professional nursing organizations and journalsDiscuss professional organizations• Available organizations per nursing specialty• Invite the residents to attend a local meeting

Encourage residents to review professional journals related to their specialty areas• Recommend journals• Reinforce during evidence-based practice project


Educational opportunities

Advancement of education• RN to BSN• MSN, PhD, DNP options• Tuition Reimbursement • Incentives• Invite variety of nurses with advancement in profession to discuss

experience• Discussion of different tracks

Professional certifications• Benefits• Incentives• Reimbursement


Professional growth within the hospital

• Clinical ladder• Preceptor opportunities• Charge nurse• Unit based resource• Committee participation• Nursing governance

participation• Incentives for RN to BSN


Application and curriculum structure discussion


• Compare the components of the curriculum to what you currently have in place

• Identify potential hospital and college of nursing resources to deliver the program content

• Discuss different ways to present materials



Evidence-based practice project• Group or individual project

• Identify a practice problem– Unit based council– Staff meeting– Observation– Nurse manager

• Literature review of research on the subject

• Formulate a change in practice

• Implement the change

• Evaluate the change



Months 1- 3

• Introduce the purpose during the first seminar

The purpose of the evidence-based project is to assist the nurse resident in applying the concepts of evidence-based practice in the clinical setting and to experience the ability to contribute to the delivery of safe, quality patient care

• Residents begin to explore and identify areas for improvement

• Brainstorm ideas in the monthly seminars

• Residents discuss potential projects with nurse managers and facilitators



Months 4 - 6

• Determine project and establish groups

• Approve topic (facilitator and nurse manager)

• Provide timelines and a mentor or contact for each group

• Provide seminar on evidence-based practice with available resources– Library resources– Mentors and researches

• Literature review

• Finalize project plan



Months 7 – 11• Implement the intervention• Data collection • Evaluation of results • Prepare presentation or poster

Month 12• Present findings in podium or poster presentation • Consider abstract submission for NRP Annual Conference, specialty

conference or a nursing journal


Successful strategies for evidence-based practice projects• Provide a structured timeline with monthly goals• Supplement EBP knowledge during each seminar• Use your resources

–Librarian–Academic partner faculty–Journals and grey literature

• Dedicate time in seminar for project work• Have project mentors and facilitators guide the residents with the EBP

project



Resources on the NRP web site• EBP project handbook

– EBP facilitator checklist – Project requirements– Project worksheet– Research report critique form– EBP models – EBP timeline– Levels of evidence– Member samples of tools


Power of the evidence-based practice project March 2019


Influencing nursing practice and policy – podium presentations • Blood Money: LCMC University Medical Center• The Sweet Spot: Modification of Hypoglycemia Protocol Allows Moms

and Babies to Stay Together: Northwestern Medicine Lake Forest Hospital• Hearing Voices: Nurse residents helping nurse residents: The University

of Kansas Hospital• An Active Shooter in the ER: How ready are we?: Houston Methodist

West Hospital• EDucate Yourself: Utilization of podcasts for staff education in the

Emergency Department: UK Healthcare• Nursing the Planet: University of North Carolina Medical Center

Over 250 Resident EBP abstract submissions for 2019 annual conference

EBP project poster winners March 2019Influencing nursing practice and policy - poster presentations• First place: Dog: A Brain’s Best Friend: The University of Kansas Hospital• Second place: Don’t Be the Ugly Duckling: Swim with the Swans, Know Your

Pulmonary Artery Waves: Penn Medicine • Third place: The "Nail-Biting Dilemma" Do Nurses who wear Artificial Nails

Pose an Infection Risk? : Grady Health System• Third place: Identifying and Decreasing Medication Administration

Interruptions to Promote Safe Patient Care Delivery: NYU LangoneOrthopedic Hospital


Graduation celebration


NRP graduation pins and certificates

NRP graduation pinsNRP pins are awarded to nurse residents at graduation or may be used as the residency experience begins to signify their status as nurse residents. The NRP pins are included in the program fee.

Vizient/AACN NRP graduation certificateNRP certificates are awarded to nurse residents at graduation from the residency program. The NRP certificates are included in the program fee.

Requests for certificates and pins should be sent to [email protected]


mailto:[email protected]

Residency program evaluation


Getting started


Take your organizational assessment

Add your residents

Understand your resident

timelines

Enter terminations or leaves of

absence

Administer the surveys

Audit Survey Taking

Analyze your

results

Evaluation and benchmarking tools


Evaluation Completed by Outcomes Timing

Organizationsite survey

Coordinator Organization characteristics,program characteristics andnational NRP programengagement

Once each year

Residencydemographicdatabase

Coordinator Demographiccharacteristics of resident

On hire or priorto start ofresidency

Casey-Finkgraduate nurseexperiencesurvey

Resident Evaluation of experience(stress, professionalsatisfaction, organization,prioritization, support, skillsand transition)

• At initial residencysession

• At six months• At 12 months• At 24 months• At 36 months



Evaluation Completed by Outcomes Timing

Vizient/AACNresidentprogressionsurvey

Resident Evaluation of progression tocompetency (autonomy, collaboration, unit engagement, unit leadership, satisfaction and commitment, patient safety, advocacy)

• At initialresidencysession

• At six months• At 12 months

Vizient/AACNpost-residencyprogressionsurvey

Resident Evaluation of progression afterresidency (measures all areasdescribed above as well asprofessional progression, educationand certification)

• At 24 months• At 36 months

Vizient/AACNgraduate nurseresidencyprogramevaluation

Resident Evaluation of program, commitmentto position, and commitment tonursing

At 12 months



EvaluationCompleted

by Outcomes Timing

NursingLeadership Survey

Nursing Leadership

at entity

Leadership satisfaction with program’s impact on unit and institution, the leadership of the residents, program’s contribution of EBP and overall view of the program.

Annually

Resident Termination Coordinator

Termination date, avoidable versus unavoidable loss, reason for termination Ongoing

Resident survey reminders


Resident survey reminders (only if resident has not completed surveys):• Day surveys opens• Surveys due in two weeks• Surveys due in two days• Surveys due date

Coordinator survey reminders


Coordinators receive status updates:• One week after surveys open• Halfway through surveys cycle

• On surveys due date

Tips to maximize resident engagement in tool completion• Encourage residents to sign up for reminders to take surveys via email

• Run report in NRP admin tool to see who has not completed surveys

• Surveys can be completed on personal devices or schedule computer time and include in agenda

• Share previous outcomes to show importance of their participation

• Emphasize organizational commitment to improving the program which relies on their feedback


Sample report from NRP Admin Tool


Survey status report

• Narrow down search• Determine who has

complete the surveys• Edit survey open/close

dates• Email residents

Sample Termination Report from NRP Admin ToolTermination report• Capture all resident terminations from your organization• View details including dates and reasons for termination• Ability to export data


Nurse Residents Survey

https://nursing.vizientinc.com/nrp-survey/

• Select: Great State Medical Center

• ID: 80_ _


https://nursing.vizientinc.com/nrp-survey/

NRP Dashboard


NRP dashboards


• The NRP dashboards deliver in one tool the quantitative and qualitative measures that comprise the NRP evaluation framework.

• Dashboards are easy to navigate and provide comprehensive:– Real-time summaries of the surveys– Benchmarking with other members – Detailed data


View overall dashboard data, or drill down into survey categories


Compare your organization’s data

with NRP participants across

the country


Review survey responses for each question and compare

with NRP programs across the

country

Casey Fink - Support


Your residents completed the surveys – now what?

New graduates are struggling with: • Feeling there are role models on

their units• Preceptors providing

encouragement and feedback • Helping to develop confidence in

practice.

This information will help clarify where your new graduates are struggling the most. This also highlights where new graduates are experiencing increased

levels of support, which is important to celebrate!

Casey Fink Nurse Survey – 21 skills


Casey Fink – SkillsDrilldown

New graduates have demonstrated increased comfort with performing codes/emergency response.


Comparative data in the NRP DashboardCreate custom comparison groups


Termination analysis


Annual analysis


• Available after one year of participation

• Benchmarking report – used to enhance the ability of NRP sites to benchmark their results against others in the program

• Outcomes report – examines the impact of the program on its graduates and to some extent, the impact of the program on the institution

• Site report – information about your site including resident demographics, retention analysis, and survey responses

• Optional regional and system reports

Dashboard and database demonstration


Develop your evaluation plan


Expected outcomes Actual outcomes

Recommendations for change

Mission and governance

Curriculum and teaching

practicesInstitutional commitment

and resources

Expected versus actual outcomes

Considerations for institution specific outcomes• Retention

• Which metrics reported from the dashboard support retention at institution?

• What metrics reported on the dashboard align with institutions mission and goals?

• What is nursing leadership’s feedback?

• Which time periods to track? 0 month, 6 month, and/or 12 month?


Example: Great State Hospital

Identified outcomes for Great State Hospital• Retention at 1, 2 and 3 years• Satisfaction & Commitment (Progression Survey) at 12 months• Organizing/Prioritizing (Casey Fink) 0 month, 6 month and 12 month• Communication/Leadership (Casey Fink) 12 month• Collaboration (Progression survey) 6 month and 12 month• Code/Emergency Response (Casey Fink) 6 month• Overall Program (Program evaluation)


Compare Great State Hospital outcomes with determined benchmark

Communicating outcomes

Share quantitative and qualitative metrics• Dashboard specific• Comments shared by nurse residents in survey’s• Stories from nurse residents to improve patient experience

Venues• Advisory Board• Nurse manager’s meetings• Board Meetings• Preceptor and Facilitator training


Scavenger hunt of Vizient website

Locate the items listed in your workbook on the Vizient website


Accreditation


Nurse Residency Program accreditation

• Increasingly hospitals with Nurse Residency Programs are seeking accreditation for national recognition of the quality of their program

• CMS does not currently fund nurse residency programs– If CMS funding becomes available, accreditation will be a

requirement

• Transition to practice programs are now required for Magnet recognition


CMS = Centers for Medicare & Medicaid Services

2019 Magnet Application Manual

• Organizations will be required to demonstrate how they effectively transition nurses with their practice setting

• Organizations seeking Magnet Recognition will have two options in meeting this new criterion

Option 1: Providing evidence of a nationally accredited transition to practice program

Option 2: Select 3 areas of transition (new graduate nurse, newly hired experienced nurse, nurse transferring, APRN or nurse manager) and describe how the organization meets the six elements of a transition to practice program


Source: ANCC PTAP, refer to ANCC Magnet Manual

Nurse Residency Program accreditation

CCNE• CCNE began accrediting nurse residency programs in 2008. The standards

were amended in 2015• Standards are available on the CCNE website (www.ccneaccreditation.org) • Crosswalks comparing the CCNE standards and the Vizient/AACN NRP

objectives are available on the Vizient NRP website

ANCC• In 2014, ANCC added Nurse Residency Program accreditation to their

existing “Practice Transition Accreditation ProgramTM”• The ANCC standards are available on their website (www.nursingworld.org) • Crosswalk table comparing ANCC standards and the Vizient/AACN NRP

objectives are available on the Vizient NRP website


CCNE = Commission on Collegiate Nursing Education ANCC = American Nurses Credentialing Center

http://www.ccneaccreditation.org/

http://www.nursingworld.org/

Record keeping

Essential for evaluation and accreditation• Seminar agendas with presenters• Content outlines and handouts• Resumes of presenters• Seminar evaluations (including presenter)• Summaries and communication of program changes made based on

evaluation results• Evaluation of resident facilitator by nurse residents• Nurse residents’ evaluation of the NRP


Marketing


Promoting program internally

• Attend manager meetings–Present outcomes–Share changes to programs–Request feedback

• Add content to preceptor class• Have advisory board members

promote the program• Monthly email blast• Newsletters• Posters displayed


Recognition

Link successes to organizational goals• Fiscal goals• Engagement goals• Quality and safety goals

Recognition• Nurse resident of the month or quarter• Preceptor of the month• Impactful EBP projects• Recognized residents/units with 100% attendance• Highlight safety stories


Promoting program externally

• Website

• Brochure

• One page handout to all new graduate applicants

• Information to schools of nursing

• Television

• Publications


Branding guidelines


• There is no program logo. Use “Vizient/AACN Nurse Residency ProgramTM” on marketing and advertising materials. Your own organization logo can be included.

• All articles submitted for publication must be reviewed by Vizient staff to assure proper attribution. No specific participating organizations, other than your own, can be included without their written permission.

• All program materials are for your internal use only and may not be shared outside of your organization

Summary


Insights learned by experience

• Advisory group is critical for policies– Attendance and commitment

• Involve your unit managers and directors– Resources and budgets, EBP projects, celebration

• Communicate expectations before hire– Commitment and expectations

• Communication about the program hospital wide is essential– Progress reports, EBP projects, exemplars

• Highlight the benefits to your hospital throughout the year


EBP = Evidence-based practice

Next steps

• Attend dashboard/database training• Enroll in monthly coordinator calls• Establish advisory board/hold first meeting• Identify facilitators and hold orientation session• Create content for first 3 seminars• Create and share first cohort’s residency calendar with residents,

facilitators, managers• Embed nurse residency information into preceptor orientation. Enhance

preceptor orientation with Vizient preceptor materials • Meet with human resources/recruiting to determine marketing

strategies, interview process, and retention data collection process• Attend nurse manager meetings


The way we were…



The way we are…

Vizient/AACN Nurse Residency Program │ 2019 │ Confidential Information140Source: http://www.prweb.com/releases/2017/02/prweb14089260.htm

Frequently asked questions

How much are the Vizient/AACN pins?There is no costs associated with these pins. They are free. Email [email protected] to order your pins

Are there preceptor resources and facilitator training? Where can I find them?Yes, in program implementation under the roles and responsibilities section.

Is there an introductory slide presentation for the nurse residents?We encourage each organization to create their own welcome and introduction to the Nurse Residency Program. Each organization can then address their policies and expectations of the residentsCan I customize my benchmarking group?Yes you can. To complete this go to you dashboard, locate the settings on the right hand side. Create your own benchmarking groups under compare groups.



Vizient support


Upcoming opportunities

NRP Coordinator Calls• July 23rd 2-3pm CT: Academic partnerships• July 31st 12-1pm CT: Community hospital coordinator panel• August 29th 11-12pm CT: Preceptors

Vizient/AACN Nurse Residency Program Annual Conference• March 9th-12th, 2020 in New Orleans, LA


NRP program support

• Program implementation training and follow-up support

• Monthly conference calls• Annual conference• List server • Bi-annual newsletter• NRP staff support• Monthly NRP Dashboard training• Monthly NRP Database training


NRP staff contacts

Jayne Willingham, RN, MSN, CPHQVice President, Nursing [email protected]

Evy Olson, RN, MSN, MBASenior [email protected]

Katie Davis, RN, BSN, [email protected]





NRP staff contacts

Angela Renkema, BSN, RN-BCProgrammatic [email protected]

Megan BuckleyProgram [email protected]




NRP staff contacts

Molly HallSenior Program [email protected]

Brooke McCarronSenior Member Support [email protected]




This information is proprietary and highly confidential. Any unauthorized dissemination, distribution or copying is strictly prohibited. Any violation of this prohibition may be subject to penalties and recourse under the law. Copyright 2016 Vizient, Inc. All rights reserved.

Contact [email protected] for more information



Documents

Vizient/AACN Nurse Residency Program · Katie Davis, MS -HSM, BSN, RN. Director, Nursing Programs: ... Residency Program • Identify the program components and how they fit into