update on phase ii of ncsbn’s transition to practice study
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Update on Phase II of NCSBN’s Transition to Practice Study. NCSBN Long-Term Care Conference August 24, 2011 Josephine Silvestre, MSN, RN Nancy Spector, PhD, RN Associate, Regulatory Innovations. 2009 New Nurse:. - PowerPoint PPT PresentationTRANSCRIPT
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Update on Phase II of NCSBN’s
Transition to Practice Study
NCSBN Long-Term Care ConferenceAugust 24, 2011
Josephine Silvestre, MSN, RNNancy Spector, PhD, RN
Associate, Regulatory Innovations
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2009 New Nurse:
“I am frightened for my patients and for my own license as I soon will be turned loose with only a resource person and expected to take a full load after only 5 days of orientation in my new assigned unit.”
- NC Transition Study
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Background…
NCSBN 2002 & 2004 Employer Studies:“Yes definitely” to survey question regarding novice graduates being prepared to provide safe and effective care:
45% (2002) & 48.8% (2004)-diploma graduates 40% (2002) & 41.9% (2004)- BSN graduates 35% (2002) & 41.9% (2004)- ADN graduates 30% (2002) & 32.9% (2004)- PN graduates
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Background…
Advisory Board Company (2008) Surveyed
5,700 frontline nurse leaders
400 nursing deans/directors/chairs
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Background…
90% academic leaders believe their new students are prepared.
10% of health system nurse leaders believe new nurses are prepared.
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Advisory Board Study
Biggest Improvement Needed:
Follow up Initiative Quality improvement Time management Tracking multiple responsibilities Conflict resolution Delegation
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Background…
NCSBN hosted the Transition Forum February 22, 2007Speakers from other disciplines and countries all
came together. Various research findings showed need for
transition programs. Stakeholders agreed to a standardized
regulatory model (AACN, AONE, ANA, NAPNES, NLN)
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The Perfect Storm Brewing…
Expertise gap (Orsolini-Hain & Malone)
10% staff are newgraduates
50% turnover from2011-2020 (Dracup & Morrris, 2007)
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Practice Expectations: Hit the Ground Running!
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Transition to Practice: A Missing Piece in Nursing
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Lack of Transition Programs Affect Safety and Quality
Patient safety
Competency
Retention
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Visual Model
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It’s a Collaborative Model
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Modules
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Illinois, North Carolina and Ohio are the Study States: 113
sites
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Transition to Practice Study
Longitudinal, randomized, multi-site study comparing patient outcomes in organizations that use our transition model versus those that use their traditional method.
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Unique Study of Transition
1. Actual patient outcomes
2. Randomization to study or control group
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Research Advisory Panel Participants
1. Jane Barnsteiner, PhD, RN, FAAN – University of Pennsylvania
2. Mary Blegen, PhD, RN, FAAN – UCSF3. Mary Lynn, PhD, RN – University of North
Carolina, Chapel Hill4. Elizabeth Ulrich, EdD, RN, FACHE, FAAN –
Versant5. Louis Fogg, PhD – Rush College of Nursing
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Research ObjectivesPrimary: To determine whether newly licensed nurses’
participation in NCSBN’s TTP model improves safety and quality outcomes
Secondary: To determine how well the preceptor module
prepares preceptors for their role To identify the challenges, and potential solutions, of
implementing the NCSBN transition model To determine cost/benefit analysis
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Survey Measurement Tools
New Nurse Surveys Demographics
Competency – NEC & QSEN
Satisfaction – Modified Brayfield & Rothe
Practice issues – NCSBN
Preceptorship experience – National Institute of Health (NIH) and North Carolina Foundation for Nursing Excellence
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Survey Measurement Tools
Preceptor SurveysDemographics
Competency – NEC & QSEN
Preceptorship experience – NIH and North Carolina Foundation for Nursing Excellence
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Phase I Patient Outcomes
Patient falls with and without injury
Postoperative thromboemboli
Hospital acquired pressure ulcers
Patient satisfaction with nursing care
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Phase I Patient Outcomes Catheter associated UTI
Central line associated blood stream infections
Failure to rescue
Medication administration errors
LOS
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Data Collection
Web-based data collection system
Surveys/evaluations Knowledge
assessments Hospital outcomes
data
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Confidentiality
Participants will receive individual password-protected access to the website
Information collected from new nurses, preceptors, nurse managers
Outcomes data entered by site coordinators will be kept confidential; data will be reported in aggregate
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Phase I - Randomization to Model or Control
Stratified by:
Rural, suburban, urban
Numbers of new nurses
Number of sites
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Phase I – June 2011
Educate institutions regarding TTP study Obtain informed consent and enroll
preceptors & their nurse managers Preceptors (intervention group) completed
training module Complete surveys
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Phase I – July 2011
Obtain informed consent & enroll new graduate nurses
Complete measurement tools Demographic & Initial surveys Knowledge Assessment
Initiate interactive online modules To be completed within 3 months of start date Each module will take approximately 6-10 hours
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Phase II
Applications are being accepted for Phase II in Ohio, Illinois and North Carolina
External validity
RNs and LPNs in settings other than hospitals
Long-term care, community-based facilities, ambulatory care, etc.
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Long-Term Care Facilities
Assisted living
Nursing homes
Rehab centers
Skilled nursing care centers
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Community-Based Facilities
Home health
Public health
Visiting nurses
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Ambulatory-Care Facilities
Free-standing urgent care
Free-standing surgical centers
Health care provider offices
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Transition to Practice Website
Located at:
www.transitiontopractice.org
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Timeline
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The Future!!
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Questions