Competency Model

• GHS Nursing Initiative

• All Nursing Roles

Staff (RN, UAPs) Preceptor CNE CNS Manager Director Affiliated Faculty

Faculty Competencies

PHASE TARGET ROLLOUT PURPOSE

Healthstream Curriculums 1st Quarter 2014 Provide specific foundational content to support faculty in various clinical arenas

Competency Validation Boot Camps

Spring/Summer 2014 Train the trainer / Validate the validator

Faculty Competency Validations

Fall 2014 Ensure faculty competency

Core Regulatory Curriculum - Clinical

Job Specific Curriculum

Department Specific Curriculum

Faculty Competencies

PHASE TARGET ROLLOUT PURPOSE

Healthstream Curriculums 1st Quarter 2014 Provide specific foundational content to support faculty in various clinical arenas

Competency Validation Boot Camps

Spring/Summer 2014 Train the trainer / Validate the validator

Faculty Competency Validations

Fall 2014 Ensure faculty competency

Nursing Safety Initiatives

• CAUTI Prevention (Catheter Associated Urinary Tract Infections)

Faculty Opportunity! We are seeing new grads struggling with Sterile Technique

• CLABSI Prevention (Central Line Associated Blood Stream Infections)

Faculty Opportunity! We are seeing spikes on units with new graduate RNs

CAUTI Bundle

• Appropriate reason for Foley insertion and daily re-assessment of continued need

• Use sterile technique with Foley insertion

• Date of insertion on orange sticker on tubing just above drainage bag

• Foley securement (STAT lock)

• Keep a closed system (red seal intact)

• No dependent loops and keep bag below level

of bladder

• BID Peri/Foley care

Peri-care for Catheterized Patients (updates)

• Peri-care for patients is performed twice a day (i.e. every shift) and whenever the patient is wet or soiled.

• Use facility approved personal cleansing wipes only:

• Wash basins are to be immediately disposed of after each use. Never re-use.• It’s important to perform peri-care prior to foley insertion.

- Hand hygiene first - Use the castile soap wipes first. Females – (3 wipes) one for the left side, one for the right and the last one for the middle, wiping front to back each time.- Use the hand sanitizer in the kit before donning sterile gloves. - Use the povidone-iodine sticks in the same fashion as the castile soap wipes.

• Documentation in the patient’s medical record under Nurse/Patient activity should reflect that peri-care is done BID and PRN.

Name of Cleansing Wipes Use Color of Packaging

Sage Comfort Bath Cleansing Washcloths May be used on perineal area and catheter Blue packaging

Sage Comfort Shield Barrier Cream Cloths May be used on perineal area; DO NOT USE ON CATHETER Gray packaging

Sage 2% Chlorhexidine Gluconate Cloth May be used only if patient is receiving CHG baths Burgundy packaging

CLABSI Bundles

• Insertion bundle

• Maintenance bundle

• Additional measures include:– Using Curos® caps if indicated– Daily CHG bathing of the patient

Nurse Extern Program Feedback

• In what ways did your experiences as a Nurse Extern differ from your experiences as a student nurse doing clinicals? I was able to have more time one on one with a nurse and ask questions and understand. I felt more like a nurse! Providing care to 4 patients is more realistic than only providing bed baths and

performing vital signs one one or two patients. It allowed me to see the bigger picture and to focus further on time management skills.

The extern program was completely different from student nursing clinicals. Seeing how many things nurses have to juggle during the day such as calling doctors, multiple patients, labs, and procedures is not something that we get to see as students only working with one or two patients.

I was able to spend more time with patients and get to know them and build a relationship with them. I feel as though it will strongly help me in the transition to the actual RN schedule as I worked 12 hour shifts 3 days a week versus doing 8 hour clinicals once a week.

I loved how I got to work with a nurse one on one compared to a group of 8 in my clinical setting at school.

The externship was very educating, having the one on one mentoring taught me so much about "why?" as a student nurse the focus is much more task oriented.

I was able to observe more patients and nursing concepts as an extern. As a student, I usually received one patient each clinical day. However, as an extern, I was able to learn and observe several patients each day at work.

Nurse Extern Program Feedback

• In what ways did your experiences as a Nurse Extern differ from your experiences as a student nurse doing clinicals? I felt like I was really helping this summer as opposed to clinicals where I often just feel like I'm in the

way since we aren't exactly shadowing nurses each day. I was able to see the whole process from the nurse's perspective. Understand what it feels like to have

multiple patients. As a nurse extern, you get to see what a normal day in the life of a nurse is. This is something you

never see during clinicals since you are only at the hospital for a max of 6 to 7 hours a day As a Nurse Extern I was attached to the hip of a mentor where as in clinical I can only do things with my

instructor who is overseeing 7 other students on the floor. One-on-one is so helpful. Not having to worry about clinical paperwork, but rather the ac of being a

nurse, was also so very nice. I felt like I had a bigger role. Rather than just going "am care" on one patient, I was able to act like a real

nurse and see different kinds of patients. As a student nurse you get one patient and they may only need one medication for the morning, this always left me bored. This was not the case in the Externship.

I think it differed because I got to see so much more than in school. Also, without the pressures of care maps and paperwork and performing skills, I was able to really begin to mentally put the pieces together of what it meant to be a nurse. I think working 12 hour days instead of just the 8 during school also allowed me to get a bigger picture of what its like to really be a nurse.

I felt more independent and in control of my learning experience. I was able to see so much more!

Nurse Extern Program Feedback

Thoughts?

Thank you!