Enhancing the ND Work Environment for Nurses

Meeting Notes

November 10, 2014

3:00 – 4:00PM CST

Project Goal: Work to retain talent through the development strategies including examining the potential for transition to practice programs, examining and the development interventions for the

workplace environment.

Meeting Started: 3:05 PMMeeting Ended: 4:05 PM

Participants: Doris Vigen, Patricia Moulton, Amy Lamb, Tessa Vandoorne, Julie Bruhn

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Group Chair- Julie Bruhn

  1. Introductions:
  1. Review notes from last meeting in August.No changes noted.

August Meeting Notes

  1. Strategy: Pilot customized Pathways to Excellence Strategy Development Program providing support through the process of identifying strategies and developing programs- There are six hospitals that are participating the pilot program. They have all submitted their priority strategies and the group is meeting in November to review the strategies and discuss a plan for customized assistance calls with AACN and in-state networking calls.

Participant Information and Timeline

Priority Strategies and Team Contacts

  1. Strategy: Engage long term care community in developing work environment programming- Current Status- Ideas on next steps for examining possible programming and develop implementation plan?

Long Term Care Survey Results

List of Potential Workgroup Members from Survey. Patricia will contact after meeting and ask them if they would like to be added to group and invited to the next meeting.

Rayne Kuntz

Tanya

Amber Nelson

Leslie Morrissey

Liz

Tamra Peterson

Feedback from NADONA Meeting:

  • Consider toolkits such as the Medication Administration Toolkit at:

The long-term care survey was completed by 15 facilities and so was an insufficient number to provide workforce demand and demographic information. The Pathways to Excellence work environment characteristics were analyzed and thirteen of the environment characteristics had been implemented by 100% of responding facilities. Characteristics that have been implemented by the least percentage of facilities include rewards and incentives for nurses who serve as outstanding role models for exceptional service, shared governance model that is integrated, mandatory overtime policy, external recognition of accomplishments and contributions of nurses, incentives for nurse managers based on outcomes, preceptor education/training, nurse manager performance measured by outcomes, and incentive pay that is based on outcomes/goal achievement.

Facilities indicated that they were not aware of or not thinking/planning for the Magnet or Pathways program and none had a transition to practice program. Three facilities indicated that they would be interested in participating in an online transition to practice program and two indicated that they would possibly be interested.

Group discussion:

  • Look at transition to practice programs. Not a one size fits all model.
  • Maybe there is some way to put together from a few different places and offer it out.
  • We change ours every year as we learn more.
  • Those that go through a transition to practice program- VA, Bethany
  • Invite the LTC individuals to our next meeting- see what they think
  • Current staff could be seasoned mentors
  • Could be an introduction for them
  • Could have NADONA send out an email to their members about their interest in a webinar and also see if they would like to help present
  • Would be nice to have people talk that have the program, don’t necessarily have to be long term care.
  • Could offer a webinar on long term care
  • Bethany has implemented some transition practice
  • The Fargo Moorhead Academic-Collaborative program group may have some ideas.
  1. Strategy: Evaluate strategies to retain/recruit LPNs in urban and rural health care facilities in ND.

Patricia indicated that she didn’t have any applicants for the research consultant- will do the work as a part of our workforce policy brief and utilize Terri Lang to develop graphs as needed. Will add out of state nursing education programs to LPN education graph on page 16

2013 Policy Report2013 Policy Brief

Notes from LPN Interest Group Meetings Regarding Recruitment and Retention-

LPN Interest Group Email List 2013-

Patricia shared some information from meetings she coordinated with several groups of LPNS in 2012-2013 in an attempt to start regional LPN associations. A lot of the comments are about the need to work on emphasizing the value (economic and as a part of the team providing direct patient care) of LPNs.

Feedback from NDONE Meeting:

  • Look at CNA pathway- have a good set of skills if encouraged to go to school to become and LPN, many education programs require CNA certification prior to entry into program.
  • 1 year LPN doesn’t articulate well into BSRN programs- miss a lot of basic sciences.
  • Many are using medical assistants instead of LPNs, some discussion about the role of LPNs versus medical assistants.
  • LPNs are choosing to not work and going straight to ADRN programs- could look at licensure database to see how many list an employer
  • Rapid turnover of all staff- new grads work 1 or 1 ½ years and then leave the state. MN and other states don’t hire new grads- send them to ND and then hire them back later.
  • Generation differences- millennials are mobile- they like to move around. Need to make them feel like they are moving around within the same organization so they don’t leave.
  • Sanford has been actively looking at LPN recruitment and retention and possible models inside their organization.

Group discussion:

  • When we only have 2 nurses on shift- LPNs are so limited that we have just gone with RNs
  • Grand Forks is working on training more LPNs.
  • The tide is turning- there is more LPNs.
  • Maybe get their perspective.
  • Identify their top priorities- identify their top barriers or strategies maybe rephrase these questions, what brought you into being an LPN, what school did you go to, what keeps you there- open-ended survey tool what keeps them in the role of the LPN and what could be better, come multiple choice and some open-ended- could expand upon a selection. What keeps you there- pay, no other jobs, family, tied to community, enjoy the work, going back to school,
  • What are their reasons to become an LPN? What was their initial expectations- were they planning to go ? What about those that choose to stay as an LPN?
  • The group decided that we should develop an online survey and send it out to LPN list and promote in enewsletter- draft survey and send to group
  • The group decided to hold on the education and Employer survey until we get these results back. We could put these results with the LTC employer survey and the demographic information that would be a part of the policy brief.

The group decided to hold on these until after the LPN survey results are back.

Starting drafting a list of targeted education programs/advisory councils and health care facilities at our August meeting and draft questions. Need to finalize lists and develop plan/timeline for collecting.

Questions for CUNEA- Education Programs- ask for Advisory Group input from eacheducation Programs and Advisory Councils

Minnesota State Technical College

Rasmussen College

EGF LPN program

Dakota College Program

Dickinson State

Turtle Mountain Community College

United Tribes Technical College

Sitting Bull College

NDSCS

  • Are your graduates successful in finding jobs?
  • Where are your graduates finding jobs (North Dakota?
  • How many are going straight from LPN to RN programs?
  • Are you filling all of your LPN student enrollment slots?
  • Are you having difficulty finding clinical placements for LPN students?
  • How do you find new clinical placements for LPN students?
  • What solutions do you have for LPN shortages?

Questions for Health Care Facilities

Hospitals- which ones?

Long Term Care- which ones? We already asked some general questions in the LTC survey.

  • What barriers in recruitment of LPNs are you finding?
  • What incentives do you have for recruitment of LPNs?
  • What work settings are you predominately hiring LPNs for?
  • Have you hired RNs into LPN positions due to low availability of LPNs?
  • If known- what is your turnover of LPNs?
  • What solutions do you have for LPN shortages?

Plan next meetings in February and April? – include 6 new Long Term Care members

Current Activity Plan: Group Meetings: June, August, November, February, April

Strategies / Activities / Month
Responsible Person(s) / Activity Completion Status
Pilot customized Pathways to Excellence Strategy Development Program providing support through the process of identifying strategies and developing programs. / Develop marketing and application materials for pilot program. Disseminate to hospitals. / June-July
Workgroup, Patricia / 25% / 50% / 75% / 100%
Collect applications, determine criteria for selecting five hospitals to include in program. Have MOA signed for each pilot hospital. / August
Workgroup, Patricia / 25% / 50% / 75% / 100%
Determine date for webinar with pilot hospitals and negotiate contract with ACNN. / August-September Patricia / 25% / 50% / 75% / 100%
Launch program including webinars and on-going support. Collect pre-assessment and baseline data from each hospital. / October-June
Patricia, ANNC / 25% / 50% / 75% / 100%
Determine whether to offer program next year or develop new programming. / February-June
Workgroup, Patricia / 25% / 50% / 75% / 100%
Engage long term care community in developing work environment programming. / Survey long term care DONs using Pathways to Excellence pre-assessment survey, determine additional issues and the possibility of transition to practice programs, best practices etc. Invite additional participation from ND-NADONA and NDLTC on group. Fall Meeting September 17-18. / July- September
Patricia. Research Consultant / 25% / 50% / 75% / 100%
Develop RFP and hire research consultant- Did not hire one. / July-August
Patricia / 25% / 50% / 75% / 100%
Examine survey results and determine priority strategies. Present to ND-NADONA and NDLTC during October meeting to gather feedback and suggestions for programming. / October-November
Workgroup / 25% / 50% / 75% / 100%
Examine possible programming and develop implementation plan. / December-April
Workgroup / 25% / 50% / 75% / 100%
Evaluate strategies to retain/recruit LPNs in urban and rural health care facilities in ND. / Develop list of possible individuals, organizations and education program to gather information about LPN recruitment/retention issues and possible solutions including retention incentives and marketing.
Determine data collection mechanism and questions. / August-October
Workgroup / 25% / 50% / 75% / 100%
Collect data/information from targeted individuals. Examine best practices in other states. Invite individuals to join group. / November-January
Patricia, Research Consultant / 25% / 50% / 75% / 100%
Examine results and best practices and determine priority strategy. Examine possible programming and develop implementation plan. / January-April
Patricia,
Workgroup / 25% / 50% / 75% / 100%
2015-2016
Possible expansion of Pathways to Excellence strategy development program to additional sites.
Program evaluation.
Launch long term care program.
Launch LPN program.