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Meridian Health System CARE: Clinical Advancement and Recognition of Excellence Program READ THE DIRECTIONSSave this application to your computerComplete the saved applicationDirections for Portfolio Development: CLINICAL SCHOLAR Read the directions and examples for each section, Clinical Practice, Education, Shared Governance and Research. Complete the fill in forms for:Cover pageManager EndorsementClinical PracticeSelf Education Peer EducationPatient/Family/Community Education Shared GovernanceResearchAttach your Resume or Curriculum Vitae Each section must be completed and verified. Do not submit copies of articles, packs of education materials, copies of meeting minutes, school papers, etc. Print the completed application beginning with the Cover Page .Submit your completed portfolio in an Interoffice Envelope. Do not use 3 ring binders, sheet protectors or submit original documents. *Your portfolio will not be returned. BCH – 2ND t floor Nursing Supervisor Office JSUMC – Mehandru 2 Nursing OfficeOMC – Same Day SurgeryRMC – Nursing Administration 2nd FloorSOMC – Nursing Resource Office 3rd floor* Please show your unit rep/educator before submission. Incomplete applications will be returned. What Are Your Credentials?What Is the Preferred Order of Credentials?The preferred order is:Highest earned degreeLicensureState designations or requirementsNational certificationsAwards and honorsWhy Is This Order Recommended?The education degree comes first because it is a “permanent” credential, meaning it cannot betaken away except under extreme circumstances. The next two credentials (licensure and statedesignations/requirements) are required for you to practice. National certification is sometimesvoluntary, and awards, honors, and other recognitions are always voluntary.What Are Examples of Credentials?Educational degrees include doctoral degrees (PhD, DrPH, DNS, EdD, DNP), master’s degrees (MSN, MS, MA), bachelor’s degrees (BS, BSN, BA),and associate degrees (AD, ADN).Licensure credentials include RN and LPN.State designations or requirements recognize authority to practice at a more advanced level in that state and include APRN (Advanced PracticeRegistered Nurse), NP (Nurse Practitioner), and CNS (Clinical Nurse Specialist).National certification, which is awarded through accredited certifying bodies such as the American Nurses Credentialing Center (ANCC), includes RNBC(Registered Nurse-Board Certified) and FNP-BC (Family Nurse Practitioner-Board Certified).Awards and honors recognize outstanding achievements in nursing such as FAAN (Fellow of the American Academy of Nursing).Reference: ANCC:American Nurses Credentialing Center. How to Display Your Credentials. ANCC, 2011. MAGNET RECOGNITION PROGRAMThe Gold Standard for Nursing ExcellenceTHE FIVE MODEL COMPONENTSAnd the Forces of Magnetism that they containTransformational Leadership1. Quality of Nursing Leadership Knowledgeable, strong nurse leaders are committed to strong advocacy and support for nursing.3. Management Style Managers involve staff at all levels of the organization. The nurse leaders provide continuous communication with staff. Feedback is encouraged and valued.Structural Empowerment2. Organizational Structure Nursing departments are decentralized with unit-based decision-making and strong nurse representation in committees throughout the organization.4. Personnel Policies and Programs Salaries and benefits are competitive. The organization offers creative and flexible staffing. 10. Community and the Healthcare Organization Hospitals maintain a strong community presence that includes a variety of long term outreach programs.12. Image of Nursing Nurses are seen as essential to the hospital’s delivery of patient care by all members of the health care team.14. Professional Development The organization emphasizes orientation, in-service education, continuing education, formal education and career development.Exemplary Professional Practice5. Professional Models of Care Nurses have responsibility, accountability and authority in the provision of patient care6. Quality of Care: Ethics, Patient Safety and Quality Infrastructure Nurses believe that they are giving high-quality care to their patients and that their organization will settle for nothing less than high-quality care. 7. Quality Improvement Staff nurses participate in the quality improvement process, see it as educational and believe it helps improve patient care within the organization.8. Consultation and Resources Knowledgeable experts, particularly advanced practice nurses, are available and utilized.9. Autonomy Nurses are allowed and expected to work autonomously, consistent with professional standards, as members of the multidisciplinary team11. Nurses as Teachers Nurses are permitted and expected to incorporate teaching in all aspects of practice.13. Interdisciplinary Relationships Nurses, physicians, pharmacists, therapists and other members of the healthcare disciplines treat each other with mutual respect and have positive relationshipsNew Knowledge, Innovations,and Improvements6. Quality of Care: Research and Evidence Based Practice Nurses believe that they are giving high-quality care to their patients and that their organization will settle for nothing less than high-quality care. 7. Quality Improvement Staff nurses participate in the quality improvement process, see it as educational and believe it helps improve patient care within the organization. Empirical Quality Outcomes6. Quality of Care Nurses believe that they are giving high-quality care to their patients and that their organization will settle for nothing less than high-quality care. Reference: ANCC Magnet Overview, Nursing Excellence. Your Journey. Our Passion., MAGBRO07v2 5M 08/08Clinical Practice Questions -Template pg. 13Discuss the following as they relate to your clinical practice. Provide specific examples whenever possible. If you like, you may include evidence to support your responses. 1. Describe how and when other nurses or members of the interdisciplinary team have come to you for your clinical judgment on challenging patient care problems/issues. 2. Provide examples of situations where your identification of early, unexpected or subtle changes in a patient with complex needs or in complex patient care situations led you to take action that would improve the outcome of the situation. In each case, describe the actions that you took and the specific outcomes that resulted from your actions especially as they relate to the key performance indicators that your unit or the hospital is following. 3. Discuss a situation in your clinical practice when you advocated for a patient, family or a group of patients. How did your advocacy result in improved outcomes for the patient/family? Describe any changes that resulted in the unit or hospital policy with regard to this patient or group. Provide specific examples. 4. Describe your experience in mentoring/precepting students or other nurses. What did you do to support the successful transition/advancement of the preceptee and/or mentee? Include outcomes (What happened to the individual who you precepted/mentored? How quickly did the nurse preceptee progress? What is your current relationship with the preceptee? Does he/she still come to you for guidance?). OrCase Study- Template pg. Use the following outline for the Case Study. All 7 points must be includedDescription of the CaseAssessment: How did you assess the situation? What data did you use? Did this situation involve the collection of data for Performance Improvement or research? Problem Identification or Nursing Diagnosis: From your assessment of this clinical situation, develop your problem list. Implementation (Interventions Selected) What actions did you take to address the problems that you identified? Identify clinical pathways, plans of care, or clinical practices used in this situation. How did the actions you selected ensure the best possible outcomes for your patient?How did your actions demonstrate the collaborative approach to delivering seamless health care services across various settings? Evaluation: (Include Patient Outcomes and Key Performance Indicators). Include how you identified changes in a patient or in the patient care situation that led to an improved outcome for your patient.How did you advocate for this patient or group of patients and how did this result in improved outcomes or in a change in unit or hospital policy with regard to this patient or group? Identify how what you have learned in this case has led to improvements in your practice.Education Questions and Documentation Template pg. 15Complete all three sections1. Self-Education: How have you expanded your knowledge base through educational achievements over the past year related to your area of clinical expertise? Describe how your continuing education is related to your clinical practice. Achievement of certification in area of specialty (Encouraged but not required). Complete the template on pg. 16. DO NOT INCLUDE COPIES OF CONTACT HOUR CERTIFICATES 2. Peer Education: How have you created/maintained a learning environment that facilitates the development of staff members, students, and/or interdisciplinary colleagues? Complete the template on pg. 16. Examples include: Presentations on a health care topic: one on one, group learning activities: Power Point presentations, evaluations Posters on pertinent patient care topic Instructor or coordinator for Competency Day/Equipment fair Preceptor Provide proof 3. Patient/Family/Community Education: How you have taken a leadership role in patient/family/ or community education? Complete the template on pg. 17. Examples include: Patient educational materials developed and/or revised such as brochures, handouts, cards, forms with directions, posters, etc. Speaker bureau activities: marketing materials such as brochure for the event Organizes a community event or takes a leadership role One on one teaching to family and/or members of a family or group. Provide proof Shared Governance Documentation – template pg. 181. Discuss how you have demonstrated leadership in patient care, on your unit, or at the hospital, professional or community level. The Clinical Scholar should demonstrate mastery of the following: Staff nurse skills considered critical in professional governance models include:Demonstrates ability to engage in decision making about patient management issues. (Examples: Is a vocal advocate for patients with family and other health care providers; does not shy away from controversy over patient management issues; has an adequate knowledge base to participate in decision making regarding treatment.) Demonstrates ability to engage in the development of standards of practice. (Examples: Knows what current standards are for patient population served; is aware of current nursing/health care research in specialty area; has worked on committees to set standards of practice for the unit.) Demonstrates ability to engage in Performance Improvement (PI) monitoring. (Examples: Is active on unit-based PI committee; is knowledgeable about nursing department QA program; can state desired outcome measures for patient population served on the unit.) Demonstrates expert conflict resolution skills. (Examples: Rarely requests/needs intervention by managers to solve conflicts; manages intra- and inter-departmental conflicts in a constructive way; has acquired formal skills in conflict management via continuing education.) Demonstrates expert negotiation skills. (Examples: Is able to negotiate requests for scheduling with peers; is able to negotiate with patients in the setting of patient goals; has acquired negotiation techniques in formal continuing education programs; is able to identify situation where negotiation is an alternative to win-lose situations.) Reeves, S. (1991). Professional governance: assessing readiness of an organization for change. Master’s thesis. University of New Hampshire; Durham, NH.Provide written proof such as signatures from chairpersons, educators, managers or members of the interdisciplinary team. Examples include: Policies revised or developed – include references Active participation in hospital/system wide committees in which you have taken a leadership role – goals achieved – What is your participation? Active participation in leadership activities in Professional or community organizations Charge nurse – What are your responsibilities? Give an example of your independent and collaborative decision making. Research Criteria & Documentation Research Criteria - Template pg. 19Activities for the Clinical Scholar level may include design or implementation of a research, EBP or PI project and dissemination and/or utilization of research results. Document how you have participated in a Research, Evidence Based Practice (EBP) or Performance Improvement (PI) project as a leader using the attached Project Template. Research Studies MUST be reviewed & approved by the campus Nursing Research Committee and may need Institutional Review Board (IRB) approval PRIOR to any data collection. See the IRB webpage for the “Does Your Study Need IRB Approval Decision Tree.” Examples of research activities include: EBP: Protocol/clinical pathway or policy developed or revised, include the purpose of the change and references (a bibliography or reference list) used. EBP: Promoting and implementing the use of existing research based nursing protocols. What exactly was your role? (NICHE protocols for the older adult) Research: Design and/or implementation of a research project or protocol as a Principle Investigator or Leader. PI: Team leader for PI activities on your unit such as National Patient Safety Goals or Unit specific issues. Provide Proof such as: Projects must be documented using the Project Template on the next page. Research may be documented in an Abstract. Do not include copies of articles, policies, protocols or full research proposals. Portfolio EvaluationYour portfolio will be evaluated based on the following indicators for each section. Clinical Practice IndicatorsThese are the indicators that will be used to evaluate your clinical practice 1. Anticipates patients’ complex needs and can identify subtle changes in the patient’s condition based on depth clinical knowledge and expertise 2. Engages in expert critical thinking and takes the necessary actions to ensure the best possible outcome for the patient. 3. Empowers and advocates for patients in a manner that improves patient outcomes or impacts/changes hospital systems. Education IndicatorsThese indicators will be used to evaluate the Education section of your portfolio. 1. Provides expert information and guidance to peers 2. Uses acquired in-depth knowledge about the care of a particular patient population to affect outcomes 3. Understands the needs of specific patient populations and develops relevant instructional materials 4. Seeks out opportunities to share knowledge and mentor colleagues. Shared Governance IndicatorsThese indicators will be used to evaluate the Shared Governance section of your portfolio. 1. Leads efforts to strengthen the numerous organizational systems and/or unit based systems including key indicators that support patient care 2. Leads initiatives to facilitate change for identified groups of patient/families, unit or community 3. Motivates and facilitates effective unit functioning 4. Improves patient care by negotiating conflict, welcoming change or problem solving effectively 5. Initiates strong physician/nurse and interdisciplinary team respect and Cooperation. Research The following indicators will be used to evaluate the Research section of your portfolio. 1. Participates, formulates, disseminates Performance Improvement/Research projects. 2. Demonstrates use of existing Research into practice, policy, procedure and/or education. 3. Includes bibliography/reference list . CARE: Clinical Advancement and Recognition of Excellence ProgramLevel IV: Clinical ScholarDescription: The nurse who progresses to the Clinical Scholar Level displays an in depth knowledge of the entire clinical practice environment and functions at the highest level in the areas of clinical practice, education, research and shared governance. The practice of a clinical scholar is distinguished by a comprehensive understanding of the impact of illness on the lives of patient and family members. In meeting patient/family needs, the clinical scholar demonstrates keen foresight in anticipating problems and concerns, is alert to the unexpected and takes steps to mitigate untoward outcomes. To achieve the best possible patient outcomes, the clinical scholar engages in expert critical thinking resulting in clinically sound evaluation and practice. He/she vigorously empowers and advocates for patients and families enabling their participation in decision making and goal setting. The clinical scholar is recognized by peers as an expert in his/her practice area or area of specialization and he/she actively and positively exerts influence on the clinical practice of other nurses and colleagues. The environment and functioning of the clinical unit is clearly enhanced when a clinical scholar is working as he/she can coordinate multiple activities and needs and often implements innovative approaches to patient and unit challenges. Patient care is distinctly improved by effective problem solving and conflict negotiation. The clinical scholar acknowledges and supports the unique contributions of the interdisciplinary team and builds and sustains relationships that strengthen a more effective patient centered care environment. The clinical practice of the clinical scholar is grounded in scientific evidence. The clinical scholar engages in, applies and/or disseminates research. The clinical scholar embraces change and challenges and shapes systems on the unit and hospital wide to achieve best possible patient care outcomes.CARE: Clinical Advancement and Recognition of Excellence ProgramPortfolio Cover SheetThis application is: FORMCHECKBOX New/Advancement FORMCHECKBOX 3 year Renewal Name: FORMTEXT ????? Credentials: FORMTEXT ?????Home Address: FORMTEXT ?????City: FORMTEXT ????? State: FORMTEXT ?????Zip: FORMTEXT ?????Telephone: Main: FORMTEXT ????? Work: FORMTEXT ????? Name Change (If applicable) FORMTEXT ????? E-Mail: FORMTEXT ?????Hospital: FORMTEXT ????? Unit: FORMTEXT ????? Date of Hire: FORMTEXT ?????Current Clinical Recognition Level: FORMTEXT ????? No. of Years at this Level: FORMTEXT ?????Level of Application: FORMCHECKBOX Clinical Fellow FORMCHECKBOX Clinical Resource FORMCHECKBOX Clinical ScholarNational Nursing Specialty Certifications Held: FORMTEXT ?????(Does not include BLS, ACLS)Highest Degree: FORMCHECKBOX Diploma FORMCHECKBOX Associates FORMCHECKBOX Bachelors FORMCHECKBOX Masters FORMCHECKBOX DoctorateNo. of Years in Nursing: FORMTEXT ?????No. of Years working with current patient population: FORMTEXT ?????The Magnet Model Components and the Forces of Magnetism are listed on pages 3 and 4. Below, identify the force(s) exemplified in each area of your application and briefly describe why .1. My Clinical Practice exemplifies Force FORMTEXT ????? because FORMTEXT ????? 2. My Educational Activities exemplify Force FORMTEXT ????? because FORMTEXT ?????3. My Shared Governance Activities exemplify Force FORMTEXT ????? because FORMTEXT ?????4. My Research activities exemplify Force FORMTEXT ?????because FORMTEXT ????? For office use only: Date Received:__________________Meridian Health SystemCARE: Clinical Advancement and Recognition of Excellence ProgramManager Endorsement for Advancement Directions: Complete and submit this form to your Manager.Name: FORMTEXT ?????Unit: FORMTEXT ?????Date: FORMTEXT ?????Current Clinical Ladder/CARE Level: FORMTEXT ?????Level of Application: FORMTEXT ?????Applicant’s Signature: ________________________________To be completed by the Manager: (Please complete and return to applicant or CARE program committee) Satisfactory Performance Review ScoreAt last Review: Yes ___ No___Has employee had any significantinfractions/disciplinary noticesover the past year?Yes___ No___I have been given the opportunity to review this portfolio and I support this employee’s application for maintenanceYes___ No___If no, give rationale for non-support:__________________________________________________________________________________________________________________________Manager SignatureDate:_____________________________________________________Print NameName: FORMTEXT ????? Date: FORMTEXT ?????Clinical Practice QuestionsDiscuss the following as they relate to your clinical practice. Provide specific examples whenever possible. If you like, you may include evidence to support your responses. 1. Describe how and when other nurses or members of the interdisciplinary team have come to you for your clinical judgment on challenging patient care problems/issues. FORMTEXT ?????2. Provide examples of situations where your identification of early, unexpected or subtle changes in a patient with complex needs or in complex patient care situations led you to take action that would improve the outcome of the situation. In each case, describe the actions that you took and the specific outcomes that resulted from your actions especially as they relate to the key performance indicators that your unit or the hospital is following. FORMTEXT ?????3. Discuss a situation in your clinical practice when you advocated for a patient, family or a group of patients. How did your advocacy result in improved outcomes for the patient/family? Describe any changes that resulted in the unit or hospital policy with regard to this patient or group. Provide specific examples. FORMTEXT ?????4. Describe your experience in mentoring/precepting students or other nurses. What did you do to support the successful transition/advancement of the preceptee and/or mentee? Include outcomes (What happened to the individual who you precepted/mentored? How quickly did the nurse preceptee progress? What is your current relationship with the preceptee? Does he/she still come to you for guidance?). FORMTEXT ?????Name: FORMTEXT ????? Date: FORMTEXT ?????ORCase StudyUse the following outline for the Case Study. All 7 points must be includedDescription of the Case FORMTEXT ?????Assessment: How did you assess the situation? What data did you use? Did this situation involve the collection of data for Performance Improvement or research? FORMTEXT ?????Problem Identification or Nursing Diagnosis: From your assessment of this clinical situation, develop your problem list. FORMTEXT ?????Implementation (Interventions Selected) What actions did you take to address the problems that you identified? Identify clinical pathways, plans of care, or clinical practices used in this situation. FORMTEXT ????? How did the actions you selected ensure the best possible outcomes for your patient? FORMTEXT ?????How did your actions demonstrate the collaborative approach to delivering seamless health care services across various settings? FORMTEXT ?????Evaluation: (Include Patient Outcomes and Key Performance Indicators). Include how you identified changes in a patient or in the patient care situation that led to an improved outcome for your patient. FORMTEXT ?????How did you advocate for this patient or group of patients and how did this result in improved outcomes or in a change in unit or hospital policy with regard to this patient or group? FORMTEXT ?????Identify how what you have learned in this case has led to improvements in your practice. FORMTEXT ?????SELF EDUCATION TEMPLATEName: FORMTEXT ????? Date: FORMTEXT ?????Type of Education – beyond required competencies (seminar, presentation, lecture, poster, school): FORMTEXT ?????Date(s) of Education: FORMTEXT ?????Topic/title of Education: FORMTEXT ?????Description of topic content: FORMTEXT ????? How have you applied the knowledge you have gained to your clinical practice? FORMTEXT ?????PEER EDUCATION TEMPLATEName: FORMTEXT ????? Date: FORMTEXT ?????Type of Education (presentation, lecture, poster, precepting): FORMTEXT ????? Date(s) of Education: FORMTEXT ?????Who did you educate? FORMTEXT ?????Topic/title of Education: FORMTEXT ?????Did you provide any written material? Describe and/or list handouts: FORMTEXT ?????Description of topic content: FORMTEXT ?????What feedback did you receive? FORMTEXT ?????Leader signature: __________________________________Print name:__________________________________Signature of attendees or signature of person who can verify the above to be accurate. (Sign in sheets can be attached). PATIENT/FAMILY/COMMUNITY EDUCATION TEMPLATEName: FORMTEXT ?????Date: FORMTEXT ?????Type of Education (presentation, lecture, poster, skills): FORMTEXT ????? Date(s) of Education: FORMTEXT ?????Who did you educate? FORMTEXT ?????Topic/title of Education: FORMTEXT ?????Did you provide any written material? FORMCHECKBOX Yes FORMCHECKBOX NoDescribe and/or list handouts: FORMTEXT ?????Description of topic content: FORMTEXT ?????What feedback did you receive? FORMTEXT ?????Signature of attendees or signature of person who can verify the above to be accurate. (Sign in sheets can be attached). Signature: ______________________________________________Print name: _______________________________________Name: FORMTEXT ????? Date: FORMTEXT ????? Shared Governance Documentation How do you participate/contribute to patient care/unit/hospital or professional decision-making? Give a personal example based on demonstrateing growth toward the mastery of the staff nurse skills considered critical in professional governance models. FORMTEXT ?????Provide written proof such as signatures from chairpersons, educators, managers or members of the interdisciplinary team. Print Name & Title: ______________________________________________________Signature: _______________________________________________________Print Name& Title: ______________________________________________________Signature:_________________________________________________________PROJECT TEMPLATE(Must be within the past 3 years)Name: FORMTEXT ????? Date: FORMTEXT ????? Name or Title of the project: FORMTEXT ????? Project Purpose: (What is the purpose of this project?) FORMTEXT ?????Project Team Members: (names of anyone else involved in the project) FORMTEXT ?????Your role in the project: (What did you do?) FORMTEXT ?????Question or PI Problem: (What is the question to be answered? What was the problem to be resolved? ) FORMTEXT ?????Methodology: (Who or what was studied? What data collection tool was used? How many subjects/situations/charts were reviewed?) FORMTEXT ?????Data Analysis: (How was the information analyzed ?) FORMTEXT ?????Summary of results: (What were the results? How were they applied? What was the final outcome? If project is ongoing, what are the results to date? ) FORMTEXT ?????Bibliography: (What references were used, articles, policies, etc.) FORMTEXT ?????Was this project presented? FORMCHECKBOX Unit meeting FORMCHECKBOX Hospital/System meeting/conference FORMCHECKBOX Local/Regional/National MeetingLeader Signature:___________________________________________________________Print Name:__________________________________________________________ ................
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