21 October 2008 - Brisbane

1. Creating a Supported Development PathwayPresenter: Ann Maree KeenanHospital: PolarisKey contact person for this project:Shane Crowe, shane.crowe@austin.org.au, and 03 9496 3370 21 October 2008 - Brisbane

2. KEY PROBLEM • Poor retention post Graduate Nurse Program (40% in 2002) • Staff reporting Graduate Program participants not work-ready • Clinical Nursing Education department focused on provision of formal programs only. Many programs were catering to external participants. • NUMs and Clinical Educators not united and dissatisfied. • Limited opportunity for nurses to get exposure to specialty areas (including ICU, ED, Theatres and HITH)

3. AIM OF THIS PROJECT Improvement sought: • Provide a supported development pathway for nursing staff • Create cultural change – where there is a team support model. • Create a learning environment, with a focus on clinical support in all areas. • Evolve and grow program over a 6 year period to include specific requirements for ED and cardiac Resources: • Expand Clinical Support Nurse positions (from 4 EFT to 9 EFT currently) • Supernumerary transition time for orientation

4. KEY CHANGES IMPLEMENTED • Revamped Clinical Nursing Education department to ensure a focus not only on provision of high quality formal programs, but also of clinical education and support. • Increase in Clinical Support EFT. • Increase in Graduate Program numbers (33% increase since 2002). • Introduction of a Practice Advancement Program (PAP) for the year following the Graduate Program – gives staff opportunity to rotate and experience additional areas and specialties not traditionally offered during Graduate Program, with continuation of clinical support.

5. KEY CHANGES IMPLEMENTED • Involved key stakeholders in program development and implementation. NUMs, clinical staff and Educators worked together to create a culture shift of supporting staff through all levels of learning and development. • Implementation of a Clinical School of Nursing model with Latrobe University, with the move to Practice Development Nurse support model for undergraduate nursing students. • Expansion and evolution of program based on the feedback from NUMs, education staff and participants in both Graduate and PAP programs.

6. OUTCOMES SO FAR • Improved retention for Graduate Program (94% currently):

7. OUTCOMES SO FAR • High post-graduate course participation, with high retention rates post-course. PAP is a primary feeder for these courses:

8. OUTCOMES SO FAR • Created opportunities for the development of our own staff. • Improved staff allegiance. Despite increase in nursing EFT each year, resignation rate has dropped from an average of 17 per month in 2002 to an average of 8 per month in 2008. • Clinical School model has nurses moving into development pathway even prior to employment. Improved matching for Graduate Program (100% computer match for the past 6 years)

9. LESSONS LEARNT • Engagement with NUMs and investing in the relationship between those staff and the Nursing Educators • Develop a partnership approach and a shared vision. • Exposing less experienced nurses to a wide variety of specialties, including ICU, ED and Theatres increases the interest in those areas. Improves the likelihood of being able to successfully recruit to those areas. • Vital to create a culture of learning across all levels of nursing – doesn’t work if it just sits with Nurse Educators. • Increased support can create increased dependence. Aim is to support staff to achieve independence. Ongoing support of the ‘supporters’ i.e. the Clinical Support Nurses to ensure this balance is maintained.