Nursing Education Needs Assessment for CY 2011-2012

OO9

Nursing Education Needs Assessment for CY 2011-2012

Type 1. New; 2. Changes in p/p; 3. High risk; 4. Problematic/QI/Safety; 5. Required

Type / Required / Source identifying need / Topic / Target Audience / Teaching
Method
ALL NSG / RN, LPN
4,5 / X / OSHA, Infection Control, CMS, TJC / Abuse & Neglect, Electrical Safety, Emergency Codes, Fire Safety, Haz Mat, IC (hand hygiene, HAI +, BBP, isolation prec, PPE, Latex Allergy), Pt Safety and Quality, Workplace Violence / X / LEARN: Safety Extravaganza
4,5 / X / Corporate Responsibility / Compliance, Confidentiality, Security, HIPAA, Privacy / X / LEARN
4,5 / X / HR; Corp Resp / Sexual Harassment / X / LEARN
4,5 / X / TJC / Anticoagulant Therapy / X / TBA
2,4,5 / X / PSFHS Policy / Code Blue, BLS / X / LEARN
4,5 / X / TJC; CMS / Cultural Diversity / X / LEARN, Newsletter
4,5 / X / TJC; CMS / Meditech Downtime / X / Staff Mtg Review
5 / X / TJC / EMTALA (ED and Triage in Birth Center) / X / LEARN, Staff Mtg review
4,5 / X / CLIA, TJC / POC Testing / X / LEARN, Demonstration
4,5 / X / CMS, TJC, AABB / Blood Administration
-Signs and Symptoms is required annually / X / LEARN
4,5 / X / NLC; Pt Safety / Falls – prevention, post fall documentation / X / UPC, peer review
3,5 / X / TJC, CMS / Restraints and Seclusion / X / Skills Review
1, 3 / X / TJC, CNO / Suicide Assessment/ Prevention / X / LEARN; newsletter
3.5 / X / TJC / Moderate Sedation –unit specific / LEARN
3, 4 / CSI, Risk/Safety, Skills 2010 / Sedation Monitoring / X / UPC, peer review
4 / No / EPA, OSHA for action not education / Pharmaceutical Waste / X / Unit Specific
4 / No / Centura Goal
PSFHS Nsg Goal,
Nsg Practice Council / Patient satisfaction/HCAHPS / X / Unit Specific; AIDET
3, 4 / No / Managers
Nsg Peer Rev
CNS, CSI / Pain Management: Chronic Pain, alternatives to meds, multimodal pain meds, polypharmacy with elderly / X / PRN Meetings, Oversedation Classes, LEARN
2, 4 / No / Patient Safety
Skills 2010
CNO
New Protocol
Managers
Nsg Leader Council
Informatics
CNS educators / Detox Patient Treatment/Safety and documentation / X / Class and
Simulation by Detox Practice Subgroup
2, 4 / X / Stroke Coordinator
ED / Stroke Alerts / X / X / LEARN
No / Managers / Epidural / X
No / CNO
CNS
Nsg Peer Rev / Critical Thinking
Unstable Patients and use of RRT / X / Unit Peer Review and meeting, Grand Rounds
No / Managers / Wound Vac Troubleshooting / X / Station at unit/service skills reviews
No / NLC / Certification - Managers / Done in NLMC
No / Rehab Therapies / Pt transfers/safe pt handling / X / Defer to Occ Health and Risk Mgt Program
No / Pt Safety / Labeling specimens / TLC
No / Pt Safety / Occurrence Reporting / X / Handouts, staff meetings
3 / No / Trauma / Chest tubes / X / MOSBY or LEARN or Station
3 / No / Trauma / Trauma C Spine / Trauma Education on units
No / Trauma / TBI
No / Birth Center
Med surg units / Central Lines / X
No / Med Surg Unit / Infusaport access, PICC, Cathflo / X / Med Surg Skills
No / All units / Workplace Safety, Preventing/reducing aggression / X / EAM; CPI Nonviolent Crisis Intervention 1/2012
No / Managers / Finance, budgeting, productivity, vision, HR, hiring, Stars, Substance Abuse or impaired staff / X
1,2 / No / CMS / Advanced Directives/MOST / X / LEARN

PSFHS Nursing Services Education Plan: 2011 and 2012

The Nursing Services Education Plan is based on a needs assessment inclusive of feedback from:

Shared Decision Making Councils including Unit Practice Councils
Managers and Directors
Risk Management
Infection Control
Clinical Effectiveness
Safety Committee
Nursing Peer Review
Online Self Assessment by nursing leaders
Requirements from accrediting and licensing bodies
New policies, practices and procedures
High risk, low volume practices

Developed by the Professional Development Council, the plan includes online learning, storyboards, classes and individual teaching methods. Unit Practice Councils have identified unique unit learning needs and shared plans to meet needs.

Back Class and TB Test
LEARN Modules
Specialty Skills Reviews coordinated by UPC’s, clinical nurse specialists and educators
Unit specific and Group specific skills/education

Additional education and training may occur based on new needs that arise during the year. The details are outlined on the following pages.

1. Personal Responsibility (Due Date: Birth Month): Back Class and TB Test

2. 2011 LEARN Modules for All Nursing Associates

Topic / Time / Due
Safety Extravaganza / 12/31/2011
Advanced Directives/MOST/End of Life Care / 6/30/11
Blood Admin – transfusion reactions, signs and symptoms / 10/31/11
Centura Compliance, Confidentiality, Privacy, security and HIPAA / TBD
Cultural Diversity-Superior Patient Experience (ADA, LEP, Rights) / TBD
Bariatric Sensitivity / 12/31/11
Stroke Module / 3/31/11
BLS Update (Calling code, chest pain center) / 4/30/11
Age Specific Education –Testout or LEARN module / 10/31/11
Moderate Sedation for specific unit / 10/31/11
Pain Management / 10/31/11
Sexual Harassment / TBD
Glycemic Control (Revised EBP in Development) / TBD
Others based on new and revised protocols and/or practices / TBD

3. Unit Based Education (UPC/Manager/Educator)

Unit
All / Competency checklist for high risk, low volume, age specific, population based
All / Meditech Downtime procedures – Review during staff meeting using documented protocols, processes.
All / Medications including IV meds administration test specific for patient populations.
All / Pharmaceutical Waste
All / Team Building/Interdisciplinary Collaboration – within staff meetings and based upon unit specific focal areas.
All / Point of Care Testing (Mary Hammel from lab coordinates)
ED, ICU, BBU, 4th, 5N, CVU, PICC, Float, 5S / TB Mask Fit Testing
All / Patient Satisfaction – in staff meetings, UPC meetings, based upon unit goals

4. 2011 Skills Review: Completed through major specialty groups (Med Surg, BC, ED, OR, ICU/CVU). Medical Surgical Units also do individual Skills Review with focused education and skill stations.

Group / Needs/Plan for 2011
Med Surg Skills Review (11, 9, 8, 7, 5, 4, 5S, 5N, Float) /

Simulation – Stroke Alert
Wound Vac – trouble shooting. education, demonstration.
POC/Glucometer check offs – Mary Hammel
Central Line Station Care, Infusaports, dressing changes
Respiratory station – OSA, vent, bipap questions, trach care, suctioning
Restraints, soft restraints, mesh beds (all); Rip restraints – RN only.
Pharmaceutical Waste
Medication Tests/IV meds
Skin Assessment Storyboard

Birth Center
Labor/Delivery
Post Partum
Nursery / 1. Critical Care (Central Lines, chest tubes, NG tubes, rapid infusers, cathflo)
2. Ambulance orientation
3. Epidurals
4. Medication test and IV meds
5. Restraints
6. PCA Pump set up
7. RRT
8. POC testing
9. Care of the Diabetic Patient
10. Lactation
11. Occurrence Reporting
11. NCC Information Board
12. Hearing Screening
13. Infant Heel Stick/Specimen Collection
14. Arms Boards and Candy Canes (Go to PACU)
15. Maternal Transport
16. EMTALA
Pediatrics
NICU
(Require BCLS, NRP and S.T.A.B.L.E) / Admissions (Bed setup, warmer bed, temp probe, servo)
Monitor/EKG leads Conscious sedation
Assessing Vital Signs Neonatal pain management
Patient Measurements Admission Charts
Bereavement Car Seat Safety
Chest Tubes/Pleurovac/Needling Defibrillator/Crash Cart
Developmental/Kangaroo Care Extreme Low Birthweight
Laboratory/Blood Bank LMA
Medication Station/Pumps/Scanning Neonatal Resucitation/NRP Update
Oxygen Delivery/Modes of Ventilation Patient satisfaction
PDA’s PICC
ROP VAP
Xchange Transfusion/Setup/Blood warmer Pharmaceutical waste
(Monthly or more frequently education provided upon request, identified deficiency, or audit outcomes. 2011-2012 additional classes to support nurses in preparing for certification exam.)
ED, Urgent Cares
Bold is same in both. Red is individual EDs.
Red = differences from each ED / PH ED/URGENT CARES
Restraints
EKG 12 lead
ART Line setup/CVP
RSI (Rapid Sequence Induction)
Conscious Sedation
Sepsis
Zoll Use
Stroke protocols/tPA
EMTALA
Hand Hygiene
NPSG
Falls Prevention
BLS Review
TAR
Meditech Infusion Therapy documentation
Sleep Apnea/OSA
Capnography
Level 1
Medication Reconciliation / SFMC ED (Assid/Buxa)
Restraints
EKG 12 lead
ART Line setup/CVP
RSI (Rapid Sequence Induction)
Conscious Sedation
Sepsis
Zoll Use
Stroke protocols/tPA
EMTALA
Difficult airway
chest tubes
Rapid infuser
venous access/huber needles
HACA
crutch teaching
mock pediatric code
hovermatt, golvo lift
sager traction
laryngoscope/glidescope cleaning musculoskeletal injury and splinting
bladder scan
pain assess
blood culture collection,documentation
Code Blue
Morgan lens
Psych patient safety & care
immunization safety/education
triage review (triage RN only)
sterile instrument processing (techs only)
patient flow (techs and US)
patient satisfaction (nurses/techs/US)
Critical Care, Cardiovascular Unit, Bariatric and Back Unit / PH CVU, ICU, BBU
1. Cardiopad
2. Level 1 Infuser
3. Pacemakers
4. Camino and Lycox
5. Hypothermia, use of Gaymar
6. VAP Bundle, use of Precedex
7. Restraints (soft, mesh beds, RIPP)
8. Mega Code
9. Huber Mat
10. I-O insertion and care
11. Capnography / SFMC Critical Care
OR / PH OR
1. Electrocautery
2. Mock Code, crash cart, defibrillator
3. Intubation cart
4. Rapid Infuser
5. Mock Trauma
6. Lasers
7. Sentinel node machine
8. Stapler systems
9. Argon beam coagulator
10. CUSA
11. RITA
12. Medrad power injector
13. Video towers
14. Phaco machine
15. Laryngoscopy setup
16. Straight shot
17. NIMS
18. Coblator
19. Stryker drills, tower
20. Jackson table
21. mayfield headrest
22. microscopes
23. DaVinci robot
24. cystoscopes
25. fracture table
26. spider
27. OSI shoulder positioner
28. OrthoPat
30. tissue log recording
31. Cell Saver / SFMC OR
PACU / PH PACU / SFMC PACU/Outpt Surgery/GI Lab
1. Art lines
2. Chest tubes
3. Hot line blood warmer
4. PCA/Epidural pumps
5. IV pumps
6. Glucometers
7. Ultrasound machine/ nerve blocks
8. Adult and pediatric crash carts
9. Airway management, O2 delivery
10. Malignant hyperthermia
11. Pain management
12. National safety goals
13. Soft restraints
14.Ttransfusion Administration record
15. GI review
16. Mitomycin disposal
Outpt Surgery / PH Outpt Surgery
1. Med Surg Skills
2. Conscious sedation
RCU / 1. Med Surg Skills
2. POC testing/glucometers
3. Conscious sedation
PH GI Lab / 1. Endoscopy equipment
2. NPSG
3. Blood Transfusions
4. Soft restraints
5. Hand hygiene
6. POC testing/glucometer
7. Conscious Sedation
Infusion Center
5 Renal /

Peritoneal Dialysis

4 Medical / Ventilator Patient Care
Stroke
TB Fit testing and TB isolation
7 Ortho Neuro / Cell saver
9General Surgical / Chest tubes
Epidurals
Nasogastric Tubes
Cervical collars
Ostomy Care
5S Medical
5N Post Op / 1st quarter-July-Sept 2nd Quarter- Oct-Dec
crash cart On Q Pain Ball/ C-Bloc
monitor/defibrillator CPM machines
Chest pain/CHF/MI Ortho Review
stroke Ice man
Cardiac drugs Pain Assessment
chest tube CADD Pump/PCA/Epidural
3rd Quarter Jan-Mar 4th Quarter Apr-June
Restraints Cath flo
wound vac PICC Lines
annual glucometer certification Kangaroo Lines
wound/ skin care Bladder Scans
diabetic update Huber Needles
hourly rounding/ hand-off reporting Hoyer Lift
11 Oncology
8 Rehab / 1. Sitter Responsibilities (CNA)
2. Ostomy Care, Wound Care, Wound Vac, D/C instructions
3. IV Review (RN); IV Station for CNA’s
4. Telemetry
5. Bladder Station (Scan, volume protocol, foley bag care, stat lock)
6. Bowel Care (Dig Stimulation, enemas, program initiation)
7. Manual BP demonstration
8. CIWA protocol
9. MRSA protocol including isolation
Cardiology/Cardiac Rehab / CARDIODIAGNOSTICS

Red rules review
Time out /TEE procedure and documentation
Moderate sedation/OSA recovery, use of CPAP
Lexiscan/Adenosine
Dobutamine stress
Definity skills check off
Case based scenario of patient having problems
Suctioning
Combative Patient

CARDIAC REHAB

Diabetic Incident
Functional Capacity – prescribing METS for initial prescription(s)
Rhythm Strip Test
Red Rules Incident
Mock Code Blue Practice
Medications (Beta Blockers, ACE/ARB, Antiarrhythmics, lipid lowering meds, antiplatelet agents) & effect on exercise hemodynamics, CAD Risk Factors
Transporting patients to ED

Wound Care / Articles reviewed and test questions answered on high risk, low volume wounds seen in the last year. Skills review using photos/simulation to describe wounds and plan treatment.

5.Nursing Group/Level Specific

Group / Lead / Needs / Strategy
Educators / Sylvia Kurko / Individual training and education based upon evaluation and goals.
Clinical Nurse Managers / VP Nsg, Directors / HR issues, Accountability, Finance, budgeting, productivity, vision, hiring, Stars, Substance Abuse/ Impaired staff / ENMO, LDI, LEARN Modules. Currently corporate developing additional training. Certification Prep Group. 1:1 computer skills upon request.
CNO / Kate McCord / LDI, IHI Conference, CONL Conf
Directors / Kate McCord / Supervision provides for individual needs assessment and learning – also included within performance appraisal. / LDI, Conferences, CONL Conf
Clinical Nurse Specialists, PICC / Kathy Guy / Individual training and education based upon evaluation and goals. Includes specialty conferences.
Charge Nurses / Managers / Leadership skills, workplace safety / LEAP, crisis intervention training.
Nurse Coordinators / Managers / Leadership skills, workplace safety / LEAP, ENMO
CNA’s / I&O, Oral Care, Catheter Care, Pain Mgt, Glucometer, Manual BP, Collecting samples, AIDET, Code Blue, Nursing Quality Indicators, Caring for “Difficult for me” patients, Bladder Scanning, M-1, Abnormal Vital signs, Pt handling and lifting, telemetry lead placement, daily weights, restraints / Occurring within skills review or individually based on need.

Nursing Leadership Self Assessment: Fall 2010 (n=17)

Topic / Strengths / Potential Education / Development strategies
Financial Management / Primarily Competent/Higher / Healthcare economics/public policy; Capital budgeting; Cost-benefit analysis. / ACO by Jackie Driscoll provided in General Leadership meeting (Winter 2011) and during Nurses Week (05/2011). Keith Humble, Finance upon request.
Human Resources / Primarily Competent/Higher
Performance Improvement / Primarily Competent/Higher / CQI, PDCA, Dashboard included several advanced beginners.
Foundational Thinking Skills / Primarily Competent/Higher / Opportunity to move from competent to expert. / Tim Porter O’Grady Conference (April 2011) - complex adaptive systems.
Technology / Primarily Competent/Higher / Opportunity to move from competent to expert. / Jill Clark providing 1:1 education in leader office. Call to arrange prn.
Strategic Planning / Primarily Competent/Higher / Opportunity for growth related to operational planning.
HR Leadership / Primarily Competent/Higher
Relationship Mgt / Primarily Competent/Higher
Diversity / Primarily Competent/Higher
Shared Governance / 100% Competent or Proficient / Tim Porter O’Grady Conference (04/11)
Accountability / Primarily Competent/Higher / Management Council peer review (professional organization participation and Nurse Executive certification) / Certification Prep Class in Colorado Springs; Study group with certified nurse support.
Career Planning / Primarily Competent/Higher
Personal Journey Disciplines / Primarily Competent/Higher / Action learning and reflective practice - Clarify definitions of these terms to further evaluate competency.
Reflective Practice / Primarily Competent or higher / Recommend Management Council discussion about self care in role and peer support.

Other Resources for Leader Professional Development.

ENMO Class for new clinical managers or upon request. New Leader Orientation.
Leadership Development Institute. Individual Coaching available. LEARN Modules. Mentoring.
Individual staff may have rated themselves lower. Recommend open dialogue with your supervisor regarding needs.

E-Learning via LEARN

Patient Satisfaction Surveys at Centura Health

Adjusting to Change to Achieve Excellence
Personal Accountability Through Integrity
Spirituality in the Workplace
Kronos Time Keeper for New Managers
STARS for New Managers
Leader Evaluation Manager (LEM) for New Managers
Success Factors for New Managers
Alternative Dispute Process
Associate Leave
ADA
Understanding Discrimination and Sexual Harassment
Rounding for Outcomes
Employee Thank You Notes
AIDET - Five Fundamentals of Patient Communications
Journey of a Claim
Introduction to Commercial Insurance
Introductions to Regulatory Insurance
Healthcare Finance Overview for Leaders
Centura Financial Basics for Leaders
CEN_Giving Praise and Recognition to Motivate Others