RU Research Conference

1. RU Research Conference

2. What is Magnet? • Highest recognition of a health care organization’s attainment of excellence • A seal of approval for quality nursing care • Recognition of facilities that uphold the tradition of professional nursing practice

3. Magnet Designation • Established by ANCC in 1993 • A culture supporting professional practice • Currently 378 Magnet Designated Hospitals – approximately 6% of US hospitals • 16 Virginia hospitals with Magnet designation

4. 16 Virginia Magnet Facilities • Bon Secours Memorial Regional - 2009 • Bon Secours St. Mary’s Hospital - 2008 • Carilion Roanoke Memorial-2003 • Centra Health Lynchburg General-2005 • Centra Health Virginia Baptist – 2005 • Inova Fair Oaks - 2009 • Inova Fairfax – 1997 • Inova Loudoun – 2006 • Martha Jefferson – 2006 • Martha Washington Hospital - 2009 • Montgomery Regional Hospital - 2009 • Reston Hospital (HCA) – 2007 • Sentara Norfolk General Hospital - 2008 • UVA – 2006 • VCU – 2006 • Winchester Medical Center - 2008

5. Benefits of Recognition • Greater recognition within the community for nursing and the hospital • Improved patient care outcomes • Improved nurse-physician relationships • Competitive marketing advantages • Improved recruitment and retention of nurses, physicians and other healthcare professionals • Enriched nursing staff satisfaction

6. 2008 Magnet Model

7. Transformational Leadership • An opportunity to deploy a group of nurses to make a change – revisiting current practices - is change warranted? • Magnet Culture has no fear of failure and modeled, accepted and absorbed by all • Nursing Strategic Plan = Roadmap with all levels of nursing contributing • This component focuses on the CNO –someone who is capable of transforming the nurses and the culture

8. Structural Empowerment • Nurses are guided, mentored, coached, and educated - consensus decision used • Showcase your nurses to promote their image • Shared decision in the workplace – shared governance, unit based decision, task forces, interdisciplinary teams • Shared decision making in the profession – professional associations, presenting and publishing, competency and certification • Partnerships with schools of nursing

9. Exemplary Professional Practice • Nurse in the model = RN • Use ANA Principles of Nurse Staffing - the ANCC does not say you have to use self-scheduling but it is an excellent way to demonstrate collaboration • Staffing and scheduling process must consider acuity, patient population needs as well as variations in patient population • Expectations in this component include – interdisciplinary care, accountability, competence and autonomy

10. Exemplary Professional Practice continued • Resources for nurses in this component include ANA Code of Ethics for Nurses, ANA Bill of Rights for Nurses and safeguarding privacy, security and confidentiality • Nurse sensitive indicators, patient satisfaction and nurse satisfaction at or above national benchmark • Must be able to differentiate between Professional Practice Model and Care Delivery System

11. New Knowledge, Innovations and Improvements • More heavily weighted for Magnet facilities seeking redesignation especially innovation • Quality Improvement • Evidence Based Nursing – using the latest EBP to guide changes • Research – systematic search for knowledge about important nursing issues • Nursing Research is aligned with the mission, vision and values; fits with the strategic plan, and will provide value to the facility

12. Research and Magnet Model • Research must be integrated into clinical and operational processes • Nurses are educated about EBP and research and support human subjects rights • Published research is systematically evaluated and used by nurses at all levels • Nurses serve on the IRB - review and vote on nursing research proposals • Knowledge gained through research is disseminated to the nurses • Resources in place to support the advancement of EBP and research in all clinical settings

13. Nursing research studies from the past 2 years, ongoing and completed are outlined in a table which includes • study title • study status • principal investigators (PI) name(s) • PI credentials • role(s) of nurses in the study • study scope (internal to a single organization, multiple organizations within a system, independent organizations collaboratively) • study type – replication – yes or no; qualitative, quantitative or both

14. Document one completed research study and describe *purpose and background *how the work was done (methods or approach) *discuss who was involved *what units participated *measurement used to evaluate the outcomes and the impact • The organization must disseminate knowledge generated through nursing research to internal and external audiences

15. Empirical Outcomes • Quality outcomes related to nursing • Clinical practice related to patient care • Dynamic and define areas of improved performance as well as additional efforts needed to achieve improvement • Most are graphically depicted • 19 outcomes throughout the other 4 components

16. At LewisGale Hospital Montgomery • Nursing Research Council leads EBP and Research Initiatives • RU partnership provides credibility and expertise • A growing culture of excellence and innovation

17. Teaching EBP • EBP five-step Model: • Uncertainty to an answerable question • Retrieval of best evidence available • Critical appraisal of evidence for validity and applicability

18. Teaching EBP Continued • Application of results in practice • Evaluation of performance

19. Searchable Clinical Questions • Gaining comfort with uncertainty • Moving clinical problems to searchable/answerable questions • PICOT format

20. Completed Studies • Music Therapy in Surgical Services • Skin to Skin Contact in Obstetrics • Bedside Reporting • Conflict Engagement

22. Corporate (HCA) Partnerships/Support • IRB consolidation/mentoring • Research consortium • Dress Study • MRSA Guidelines • Wound Staging

23. Administrative Support • Continuing Education Opportunities • Local • Regional • National

24. Future Studies • ICU Quiet Times • Dedicated Education Unit • Care Delivery Models • Hypothermia approaches in the ED • Bedside reporting-validation study

25. “Flo” Said It Best “Improved statistics would tell us more of the relative value of particular operations and modes of treatment… and the truth thus ascertained would enable us to save life and suffering.”

26. References • Application Manual, Magnet Recognition Program (2008) • Aravind, M. & Chung, K. (2009) • Fineout-Overholt, E. &Johnston, L. (2005)