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CNIII Workshop 2016

Feeling Cared For

http:// edr.ucsd.edu

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Objectives for Part 1 of 3

1. Demonstrate how our Professional Practice Model ties

into the CNII – CNIII promotional process.

2. Define a CNIII nurse.

3. Explain the CNII-CNIII reclassification requirements.

4. Identify resources for project development.

Frequently asked questions

What does it mean to be CNIII?

• Definition of CNIII – Functions as a clinical expert and resource for an assigned patient care area. Competent to function as charge nurse and/or preceptor.

• CNIII nurses maintain their status through active involvement at the unit and/or organizational level according to defined maintenance criteria.

How do I know if I qualify to become a CNIII?• Minimum of 1 year of experience within specialty area.

• Must not have had disciplinary action within the last 12-month period.• Must “meet” or “exceed” standards on performance eval.

• Active participation in council or committee (60% attendance within 12 months

• Endorsement of project by current nurse manager within 12 months of presentation to PDC.

What is the first steps towards obtaining my

CNIII status? Talk with your manager about

your performance and determine if you qualify

as a CNIII candidate. Manager approval must

be obtained .

What type of project is expected of me?

• Evidence Based Practice (EBP)

• Performance Improvement (PI)

Where can I get ideas for CN III projects?

• Ideas for CN III projects can come from a

number of sources. Talk to your manager,

educator, peers, and patients. Keep in mind

projects are most effective if it pertains to a

personal interest or passion.

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Can I work on a project with other nurses?

• Yes, per group project criteria

• Approval of the group project is required PRIOR to initiating project to ensure timely guidance. (Contact the PDC

chair to schedule time on the agenda)

• Project is present to the PDC committee by the mentor or mentor must be present

o Project type and outcomes are defined

o Individual roles and responsibilities are clearly defined.

o The number of group members is defined

• When complete, each group member presents portfolio and their work independently.

CNII – CNIII Group Project Criteria

1. Group projects need a designated Mentor with a MSN (APRN

or CNE); knowledgeable of the CIII promotional Criteria

2. Each candidate must meet CNIII criteria.

3. The group project will have similar or common objectives.

4. Projects follow a common framework (PICO, PDSA or

Research) but are individualized to reflect work of each

candidate.

5. Each project has a coordinated dissemination/enculturation

plan.

GROUP PROJECT EXAMPLE

Manager

• Meet and communicate regularly to discuss

your progress and road blocks

• Managers are able to identify resources and

directs nurses to appropriate experts

• Review project and outcomes before presenting final work to PDC

• Invite your manager to attend your scheduled

PDC presentation to support you!

• Once you are a CNIII – CNIII maintenance

must be maintained annually and evidence is given to your manager at your annual

performance evaluation.

Mentor

• Choose a mentor familiar with the CNII to

CNIII process

• Meet and communicate regularly to discuss

your progress and road blocks

• Review project and outcomes before presenting final work to PDC

• Please have your mentor attend your

scheduled PDC presentation to support you!

Support and guidance from your manager and

mentor are hallmarks of successful CNIII projects

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EBP vs. PI vs. Research

Three forms of projects to improve practice

Objectives Part 2 of 3

• Describe characteristics of a PI, EBP, and nursing

research project

• Review elements of PDSA model

• Describe elements of a PICO Question

• Identify outcomes to measure project results

How do I use literature for my project?

• Support the change concept!

• Come up with ideas!

• Support your interventions!

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Differentiate Between QI, EBP, Nursing Research

Outcome measures

• Projects have to include measure of the outcomes

• Outcome measures have to match the goal of the project

• Ex. Project to decrease falls• Staff knowledge of fall risk assessment?

• Staff compliance with yellow charms?

• Staff satisfaction with policy?

• What else?

• Ex. Changed pain assessment to valid and reliable tool.• Staff knowledge of pain assessment tools?

• RN and MD satisfaction with new pain order sets?

• Patient reported pain score episodes > 8.

• What else?

Project Type: Performance Improvement (PI)/Quality Improvement (QI)

Framework: PDSA

Aim Statement: Overarching statement regarding intention of project (often begins with “improve,

reduce, and increase” etc.)

P (Plan) – Development of your project

What are your project objectives?

What empirical measures are planned to study the effectiveness?

What is your baseline data?

What is your target measurement?

What is your benchmark measurement?

D (Do) – Structure and Process

What roles, resources, equipment, supports, systems and actions are taken?

S (Study) – Empirical Outcomes and Analysis of Findings

Compare outcomes with your baseline data, target measures, benchmark measures and project

objectives.

Did you achieve your desired outcomes?

A (Act) – Dissemination and Enculturation

What changes are taken as a result of your outcomes?

Do you need to make a change and begin another cycle?

How have you disseminated and enculturated your project outcomes?

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UCSD EBP Model: Brown and Ecoff

Project Type: Evidence Based Practice (EBP)

Framework: PICO

P (population/problem)

What is your target population?

What is the focus or problem you are exploring?

I (intervention)

What is the intervention or practice change you are exploring?

C (Comparison)

What interventions are currently being done?

O (Outcomes)

What empirical measures are used for data collection?

What data is used to demonstrate the impact on the patient, the nursing

workforce, the organization, and/or the consumer?

Focused PICO Question: In or among your (patient/population), does your (intervention), versus your (comparison), result in or affect your (outcome)?

Nursing Research Projects

• Not required for CNIII advancement.

• Typically an option used by RNs completing graduate or

doctoral studies.

• May be an outcome of your smaller project.

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Turning Team

• A med surg unit wanted to find a way to make sure that all their patients were turned routinely.

• The evidence-based nursing guidelines of care include routine turning as one prevention intervention for hospital acquired skin breakdown.

• A unit turning team schedule was implemented and a staff satisfaction survey was sent out.

• Is this:• EBP

• PI

• What “outcomes” could strengthen this project?

Urinary Catheter Project

• The CAUTI rates in this unit are high

• Nurse manager asks for staff volunteers to make a audit team

to monitor compliance with the CAUTI prevention bundle.

• You volunteer, IF it can be used for CNIII project

• What would need to happen first?

• What first steps would be important to the project success?

• Is this

• PI

• EBP

• Research

Meditation Tape

• Julie is a certified healer

• She is passionate about the benefits of meditation for

stress and pain

• She wants to share her passion with coworkers and

creates a short meditation tape (<10 min) for them.

• After 5 weeks, she asks how many of the nurses listened

to the tape and how often they ‘meditated’

• Is there something she can to make the project stronger?

• Is this:

• PI

• EBP

• Research

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SSI/C-Section Project• Surgical site infections following C-Section are

problematic

• How would staff RN know this?

• What steps could you take to improve?

• How would you measure improvement?

• Is this:

• PI

• EBP

• Research

Project Support

• Select and meet regularly with your mentor

• May not be in your dept.

• Literature reviews

• Mary Wickline: mawickline@library.ucsd.edu

• X41196

• Biomedical Library between Biomedical Science and Leichtag

Buildings.

• Judy Davidson Nursing Research and EBP Liaison

• jdavidson@ucsd.edu for support

• Help with project design or publication

• Help with finding a content expert

Sustainability and Dissemination

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Professional Development Council 2016

Professional Portfolio

Objectives for Part 3 of 3

1. Describe the purpose of a Professional Portfolio; as it

relates to a CNII to CN III project.

3. Discuss the components that make up the portfolio.

4. Describe expectation of presentation of project and

portfolio to PDC.

What is a Portfolio and Why?

• A collection of the nurses’ work

• Used to gain a broader understanding of the nurses performance

• Description of Project

• Information organized in a clearly delineated format

• Evaluated based on clearly delineated criteria

• CNII-CNIII reclassification criteria

• Used to share work

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Portfolio Tips!

• Start this early. Don’t leave it until the end!

• Develop your portfolio as you go. Keep details and

organize your work from the beginning

• Keep a reference list

• Review recent peer examples

• Don’t forget to use the checklist found at the end of the

current CNII to CNIII reclassification Standards

Portfolio Content

• Table of Contents

• 200-250 Word Abstract

• Curriculum Vitae/Resume

• Copy of current performance evaluation

• Four letters of recommendation for CN III reclassification

• Documentation of a minimum of 60% attendance in unit based or hospital

based committee or council

• Copy of current specialty certification or copies of certificates that verify 30

CE’s completed with the last 2 years

• Description of Project and Outcomes

• Magnet Documentation

• Professional Practice Model Documentation

• Reference List

Description of Project

• Identify project type and framework (EBP using PICO or QI/PI using PDSA)

• State PICO question or Aim Statement

• Use word format

• Use framework, answer associated questions and provide

detailed descriptions, examples, resources and materials to

elaborate on your responses.

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Magnet documentation

• To meet Hospital Magnet requirements Sources of Evidence (SOE) are

Submitted.

• Which 2 Sources of Evidence does your project align with? Briefly

Explain.

Professional Practice Model Documentation

• How does your project aligns with our Professional Practice Model

• Select 1 element; Briefly explain

If brainstorming for project topics, consider possible projects that will align with the Nursing Strategic Plan

•Healthy Work Environment

•Nurse Recognition

•BSN/MSN, Certification

•CAUTI, CLABSI

•Pressure Ulcers, Falls

•Patient Satisfaction (PG Overall)

•UBC: At least 1 project per dept., active UBC

•Share Knowledge

•LOS acute/LOS ED

•Budget

What difference will you make? (Patient, Nurse, Consumer, Organizational)

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When your portfolio is complete…..

• Ensure completed hardcopy and electronic copy

• Schedule presentation to PDC on-line http://medcenter.ucsd.edu/EDR/DEVELOPMENT/COUNCIL/Pages/default.aspx

• Prepare a 10 minute presentation• What is your project type and framework?

• What was your PICO question or Aim Statement

• Describe your process and focus on your outcomes! What difference did you make and how do we know this?

• Be prepared to answer questions from the PDC members

• After your presentation complete the on-line database https://health.ucsd.edu/medinfo/nursing/edr/research/Pages/schedule_presentation.aspx

Frontline Leadership Academy (FLA)

• FLA program objectives are based on leadership

development and NOT CN III project development

• Project potentially may meet CN III project requirements

with guidance

• Any FLA member that otherwise qualifies for CN III

promotion can schedule time to present their FLA project

to the Research Council for evaluation and guidance.

Group Discussion

• Project Ideas? Questions?