Contents of Clinical Ladder Portfolio

For Re-Applicants(2nd year of clinical ladder designation)

TCCH Clinical Ladder Applicants

Welcome Letter

Clinical Ladder Description (Tab 1)

Eligibility Requirements

PRISM Compensation

Criteria for Clinical Ladder Levels

Professional Practice Model Grid

Application Process (Tab 2)

2013 Application Timeline

Application Process for 2nd year

TCCH Clinical Ladder Applicants

Responsibility of Applicant

Role of the Mentor

Letter of Recommendation Guidelines

Continuing Education Requirements

Criteria for Exemplars

Professional Contributions Guidelines

Application Forms (Tab 3)

Letter Of Intent

Clinical Ladder Application for Re-Applicants

Checklist for Application Packet

Clinical Ladder Application- Signature Page

Director/Manager Checklist

Verification of Hours Worked Form

Letter of Recommendation Form

Preceptor and Leadership Verification Form

Volunteer and Community Service Verification Form

CE Documentation Log

Committee Log

Presentations Log

Research/Publications Log

Useful Information (Tab 4)

Professional Development Council Members

Description of Clinical Practice Exemplars

Overview of Kristen Swanson’s Five Caring Processes

Example of Nursing Exemplar

Selection Committee

Appeals Process

Frequently Asked Questions

Welcome Letter

Greetings!

The ChesterCountyHospital and Health System has a history of excellence in nursing practice. This has been established over the years as a result of the hospital’s ongoing support of the nursing profession. In an effort to continue the advancement of nursing and support of frontline staff, in 2010 the Professional Development Council instituted PRISM (Professional Recognition of Initiative, Skill, and Merit) a clinical ladder for nursing, with the first recipients designated in December of 2011.

As a result of input received from successful applicants during the first year, a few changes have been made to the application process. In the near future, a “PRISM” section will be found under the Nursing tab on the hospital team website. This section will include instructions and the actual logs needed to document your individual accomplishments. These forms can be downloaded and completed on your personal computer. While the use of the online forms is encouraged, a hardcopy application packet will be provided by the PDC, upon request.

Regardless of how the forms are accessed, an official PRISM binder and dividers will be provided by the Professional Development Council. These binders will be made available to you upon receipt of a formal letter of intent. Of note, the letter of intent will be accepted until March 1st, 2013. For your convenience, a letter of intent form and an application timeline are included in this packet.

New for 2013:

  • ALL applicants MUST select a mentor from the mentor listavailable on the PRISM website, and work closely with him/her. The mentor’s role is critical to your success.
  • Your completed binder and interview will be weighted in determining successful clinical ladder attainment.

Thank you for your interest in PRISM!

The members of the Professional Development Council

Clinical Ladder Description (Tab 1)

Eligibility Requirements

While the hospital recognizes the contributions of nursing across the spectrum of healthcare, PRISM was developed to provide recognition and retention of the nurse at the bedside in an acute care setting. Therefore, basic eligibility criteria to apply for PRISM include:

Position title of Staff RN or Charge RN in an acute care setting

936 hours of actual time worked in an acute care setting

Being in good standing; free of disciplinary actions

Minimum annual evaluation score of 3.00

For further details, please refer to the “Criteria for Clinical Ladder Levels” found on page 6.

PRISM Compensation

Purpose: Compensation, which includes payouts and awards for attaining PRISM, is designated to align with the goal to motivate and reward exceptional performance among Registered Nurses who have met the qualifications of the PRISM program. This program has been established to recognize the frontline nurse and to attract and retain nurses with outstanding ability.

The PRISM binder and applicant interview will determine whether the nurse’s efforts met the necessary criteria during the past year.

If at any time it has been determined that a recipient/applicant has violated any policies or performance standards during the award period, the hospital in its discretion may remove the recipient/applicant from the program such that the recipient/applicant does not earn any compensation or award.

The Hospital reserves the right to deny compensation. In exercising its discretion to deny compensation, the Hospital may consider, among other things, whether a recipient/applicant has received any writtencorrective counseling documentation. If a recipient/applicant is placed in the Progressive Disciplinary Action Process, the Clinical Ladder designation and financial incentive will be forfeited.

Criteria for Clinical Ladder Levels

Clinical Level / Basic Requirements / Additional Points
From Criteria
Clinical Level One /
  • RN Licensure

Clinical Level Two /
  • RN Licensure
  • 18 months of current nursing experience
  • 1 year of employment at TCCH as an RN,
  • BSN orcertification in specialty oractively working toward BSN with 6 credits completed
/ + 75 Criteria Points
Clinical Level Three /
  • RN Licensure
  • 3 years of current nursing experience
  • 1 year employment at TCCH as an RN
  • BSN and certification in specialty
/ +100 Criteria Points
Clinical Level Four /
  • RN Licensure
  • 5 years of current nursing experience
  • BSN and certification in specialty
  • MSN/Masters in healthcare related field or actively pursuing with current enrollment and completion of a minimum of 6 credits
/ +125 Criteria Points

Professional Practice Model Grid

The Professional Practice Model Grid consists of 4 components:

  • Clinical Expertise Criteria
  • Professional Accomplishment Criteria
  • Education and Certification Criteria
  • Community Development Criteria

Clinical Expertise Criteria / Individual Points / Total Points / Description of Activity / Signatures
Years of Nursing Experience
(Bedside experience)
1-5 years……..2 pts
6-11 years……4 pts
12-15 years…..6 pts
15-25 years… .8 pts
25 years +…. ..10 pt
Evaluation Score
3.00-3.49………2 pts
3.50-3.99………4 pts
4.00+………….6 pts
Preceptor Experience
Attendance at Preceptor Workshop within 5 yrs……………..2 pts
Mentoring a student or precepted a new hire (excludes nrsg students with instructor on premises)
Points based upon hours of involvement
40+ hours……….5 pts
80+ hours……...10 pts
160+ hours…….15 pts
Leadership Experience
Functions in a leadership role while maintaining a full patient assignment (excludes those hired into a charge RN role)
Less than 40 hr/yr….4 pt Greater than 40 hr/yr..6 pt
Super-user in one area………………….8 pt
Super-user in more than one area……………12 pts
Quality Improvement
Suggests and initiates a process improvement with the intent of improving pt outcomes…………..15 pt
Involved in collection and evaluation of data that will help to improve patient outcomes…………..20 pt
Active Participation in writing Regional/National Quality Award Application………..4 pt
Total Points
Professional Accomplishment Criteria / Individual Points / Total Points / Description of Activity / Signatures
Professional Healthcare Organization
Current membership in a Professional Healthcare Organization……….4 pt
Active in local chapter of professional healthcare organization (minimum attendance 1 meeting/quarter……4 pt
Attendance at meeting of healthcare organization
Regional…………4 pt
National …………6 pt
Committee Activity
Chair of a unit/hospital committee…..16 pts
Co-chair of a unit/hospital committee….10 pts
Participation as a committee member on a standing committee..5 pt
Participation as a committee member of an ad hoc committee….2 pt
Participation in a hospital or unit based process improvement project……………..4 pt
Research and Publishing
Participation in a research project…10 pt
Author of published research project…20 pt
Author of Policy and Procedure (Must attach policy/ies) …………5 pt per policy, max of 20 pts
Tenure (total hospital tenure)… 1 pt/every 5 yrs
Nursing or Professional Award
Recipient…………5 pt
Nominee…………2 pt
(for each award)
PRISM Mentor
Attended Mentoring
Workshop………….1 pt
Mentor to PRISM applicant…………2 pt
(per applicant, max. of 10)
Total Points
Education and Certification Criteria / Individual Points / Total Points / Description of activity / Signatures
Educational Level
BSN……………4 pt
BA/BS………....2 pt
MSN…………...6 pt
MA/MS………..4 pt
PhD……………10 pt
Certification
Certification (initial or renewal)…20 pt
Presentation Skills
Development and initial presentation in an informal setting…10 pt
Repeat presentation of same material…….5 pt
Division presentation……….15 pt
Hospital wide presentation……….20 pt
National/external presentation……….20 pt
Teaching Skills
Certified teacher/trainer in a healthcare related field……………...15 pt
Educational Coursework
Current coursework in a healthcare related field from an approved institute of higher learning….1 pt per credit hour
CE Credits
20-30…………..2 points
31-50 ………….4 points
above 51 ………6 points
E-Journal Club Presenter………10 pt
Total Points
Community Development Criteria / Individual Points / Total Points / Description of Activity / Signatures
Volunteer Activity
Participation in healthcare or community related activity (i.e. AHA, ACS, Leukemia Foundation, Heart Walk, Dash for Diabetes)……..…2 pt/ea
Max of 6 pt
Individual or group volunteer at a church, school or community activity with a minimum of 20 hr/yr involvement……4 pt
Leader or chair of a large scale community volunteer activity (40 hr/yr minimum involvement………10 pt
Active member of volunteer group supporting hospital related activity (i.e. May fest)…………3 pt/ea
Max of 6 pt
Total Points
Total Points from All Categories in Professional Practice Model Grid

Application Process (Tab 2)

2013 Application Timeline

January 2013 / PRISM Application Available for download online
March 1st, 2013 / Deadline for Intent to Apply decision
Complete the intent to apply form
and email to S. Henrick or C. Weidman
September 7, 2013 / Completed PRISM binders due
September 21, 2013 / Interviews scheduled with letters sent to applicants
(Initial and 3rd year applicants only)
September 24
through
November 162013 / Interviews performed
(Initial and 3rd year applicants only)
December 18, 2013 / Notification of awards
January 2014 / Implementation of financial incentive associated with PRISM

Application Processfor 2nd year

TCCH Clinical Ladder Applicants

Application packets for the Clinical Ladder PRISM are available on the team website under the nursing tab.

The applicant may also choose to contact a member of the Professional Development Council (PDC) to verify completeness of the application prior to submission. Upon request, a member of the PDC/mentor will review and offer suggestions to improve the application portfolio of staff prior to submission.

The applicant must:

  1. Meet minimum qualifications
  1. Submit a complete application portfolio containing the following:

See checklist for content and order

  1. For Initial and 3rd year applicants only:

Attend a Selection Committee meeting for interview and presentation of exemplar(s) and clarification of the other parts of the application portfolio if needed.

  • Applicants will be notified of the date of the Selection Committee interview within fourteen (14) days of the submission deadline.
  • All Selection Committee interviews will be scheduled within sixty (60) days of the deadline.
  • During the interview:
  1. Candidates will be asked to answer questions about any aspect of the portfolio contents in a clear, knowledgeable, and succinct fashion.
  1. Candidates will be asked to clearly present either one or both exemplars.

Decisions regarding designation of Clinical Ladder status will be awarded upon completion of all interviews and evaluations.

Responsibility of Applicant

Provide the best possible documentation of his/her clinical practice, leadership, and professionalism to the Selection Committee ahead of or before the deadline

Ask for timely assistance from a mentor or Selection Committee members. Attend workshops for applicants. ( encouraged, not mandatory )

Attend an Selection Committee meeting for interview, presentation of exemplars, and clarification of portfolio if needed.

If needed, appeal to the Selection Committee in writing within 30 days of the original decision.

Successful applicants need to become familiar with requirements to maintain their new status including renewal requirements

Role of the Mentor

ALL applicants(with the exception of the mentors themselves), must choose a mentor to assist in the application process. We have found from experience that the use of a mentor directly impacts the quality of the PRISM application.

Over the past two years, the committee has seen binders that were disorganized and interviews that were not professionally conducted.

New for 2013,

(1)The completed binder and interview will be weighted in determining successful clinical ladder attainment - binder (75%) and the interview (25%)

(2)Everyone will be asked to follow a specific format for document placement.

Applicants with mentors will be aware of selection committee expectations, while those without a mentor, may not; which could impact scoring.

For your convenience, the PRISM website will contain a list of mentors that you can choose from.Mentors listed are current PRISM clinical ladder recipients who not only have personal experience with the PRISM process, but also have successfully completed a mentoring workshop offered by the Professional Development Council. They can best guide you during the development of your application and significantly improve your chances of success.

The role of the mentor is to review your application portfolio for completeness before it is submitted to the committee. It is your responsibility to engage this valuable resource in providing constructive feedback to improve your application portfolio, answer questions, provide professional guidance, support, and counsel you in preparing for the interview portion of your application process.

Apart from the professional rewards of being a mentor, the Professional Development Council recognizes this valuable contribution and awards clinical ladder points to mentors.

Attending the Mentoring Workshop offered by the Professional Development Council / 1 point
Mentoring a colleague / 2 points per colleague, for a max. of 10 points

Letter of Recommendation Guidelines

The Staff Nurse Clinical Ladder applicant functions in the acute care clinical setting as an exemplary care-giver to patients, a model of proficiency for co-workers, and a colleague to physicians. Part of the application process requires that applicants submit letters of recommendation from peers, supervisors/managers, and other healthcare team members familiar with the applicant’s practice over the past year.

Letters should be legible, be brief, and indicate the nature and dates of your association. Please submit a letter of recommendation from each of the following parties who are familiar with your practice over the last year. All letters must be dated within 12 months of the application deadline.

  • A RN peer familiar with your practice
  • A supervisor (a nursing supervisor familiar with your practice)
  • Another health team member (MD, PT, Social Worker, etc.)

Required components of this document include:

  • Name of recommender
  • Name of applicant
  • Date of recommendation
  • Relationship to applicant

Continuing Education Requirements

Applicants must have a minimum of 15 Continuing Education credits in the area of the applicant’s clinical specialty. Continuing Education must be within the 12 months before the application deadline.

Courses that are approved by the State Board of Nursing or the Continuing Medical Education (CME) shall be applicable. ACLS/PALS/NALS is NOT applicable. Determination of applicability to clinical specialty will be made by the Selection Committee.

Photocopies of CE’s, CME’s, college credit certification, need to be included in the portfolio when the application is submitted.

More than 15 CEU’s may be submitted with the application packet in case some of the CEU’s do not meet requirements. Candidates who have taken more CEs/CMEs will be rated higher.

Criteria for Exemplars

To assist you in writing exemplars, the following information (pertinent to the evaluation of exemplars) is offered:

1.Two written exemplars must be submitted for review. The exemplars must be reflective of events that occurred in the last twelve (12) months.

2.Type the exemplars in a clear, professional, understandable style.

3.Identify the theories of caring being addressed within the exemplar:

The same theories of caring can be used in both exemplars, or different theories of caring can be used

4.Exemplars include information about any of the following:

How you felt about the situation

Why you felt that your actions were important

Why the actions were important

Why the actions may have been different from someone with less experience

5.Describe in the exemplar a clinical situation that was positively impacted by your practice.

6.Demonstrate/illustrate excellence in your exemplar.

7.Describe in the exemplar how you personally made a difference.

8.Illustrate the use of fine discretionary judgment in the exemplar.

9.Write the exemplar in your own words. Uniqueness and individuality are important.

A description of Kristen Swanson’s Theory of Nursing and a sample exemplar are located under the “Useful Information” section.

Professional Contributions Guidelines

Participation in two (2) of the following within the past twelve (12) months is required.

  1. Active participation in quality activities which must be of an ongoing nature

with participation occurring over at least six (6) months of the past year, e.g.

Patient Safety Taskforce.

  • Committee work may be hospital or professionally based
  • Unit Council Facilitator or member
  • Hospital of Distinction taskforce member
  • Professional Development Council
  • Relationship Based Care Council
  • Other

The applicant must document the role of the committee, meeting frequency, and your individual contribution by completing the form on committee participation documentation in the packet.

  1. Teaching Activities

Community teaching must be voluntary. Teaching activities are not necessarily ongoing in nature. They may be significant one-time events.

  • Formal Inservice/Presentation
  • Informal Inservice/Presentation
  • Community Teaching (community teaching must be voluntary)
  • Health care related research
  • Development and/or presentation of patient education programs
  • Precepting
  • Orienting/cross-training
  • Other

Examples are: teaching guidelines, new grad preceptor, assisting with a complex skill day or facility-wide training, such as MAK Superusers. Examples of health related community work are: a school demonstration project, involvement in a respite program, active participation in a health fair or health screening, teaching a first aid course. A brief narrative describing your role in the projects/programs, for example, time involved, class objectives (if appropriate), audience and results should accompany your portfolio. For publications, please enclose a copy of the article you wrote.

III.Leadership Activities

  • Act as a Resource nurse for staff
  • Special Projects/Presentations
  • Community Service (must be voluntary)
  • Mentor one new graduate RN within the last twenty four (24) months
  • Policy and Procedure activities
  • Other

An example of policy and procedure activities would include the actual writing of a standard/policy or involvement in the annual review of the same. A sample of the policy should be included in the portfolio.