Presented by:Jennifer Edeogu BSN, RN

Yvette Heflin BSN, RNKatrina Hernandez BSN, RN

Jacquelyn D. Svoboda RNC, MSN,WHNP

In Partial FulfillmentOf the Requirements for the Course

GNRS 5411 Program Evaluation: EducatorSummer 2014

The Assessment Process & The Impact upon Professional Nursing

Practice

At the conclusion of this Module, the audience will be able to: Describe the history of the Magnet

recognition. Describe the criteria for the Magnet

recognition. Understand the preparation for Magnet

recognition. Describe the evaluation process for Magnet

recognition. Describe the impact of Magnet recognition

of the professional nursing practice.

History & Power of Magnet Recognition: 1981- began as a research study Committee established by American Academy

of Nursing Nursing Shortage 41 of 150 hospitals were recognized as

Magnet Based on recruitment and retention Resulted in recognition of 12 themes, Forces

of Magnetism (Westendorf, 2007)

History & Power of Magnet Recognition: 1993- American Nurses Association (ANA) through

the American Nurses Credentialing Center established the Magnet Recognition Program (Sullivan & Johnston,2004)

Objectives (Sullivan & Johnston,2004) 1. Recognize nursing services 2. Promote quality 3. Provide a means of successful nursing practices &

strategies 4. Promote positive patient outcomes

1. Quality of Nursing Leadership 2. Organizational Structure 3. Management Style 4. Personnel Policies and Programs 5. Professional Models of Care 6. Quality of Care 7. Quality Improvement 8. Consultation and Resources 9. Autonomy 10. Community and the Health Care Organization 11. Nurses as Teachers 12. Image of Nursing 13. Interdisciplinary Relationships 14. Professional Development

Model classifies the 14 Forces of Magnetism into 5 Components Transformational Leadership ( Force 1 & 3)

Structural Empowerment (Force 2, 4,10, 12 & 14)

Exemplary Professional Practice (Force 5, 8, 9, 11 & 13)

New Knowledge, Innovations & Improvements (Force 7)

Empirical Outcomes (Force 6)

Organization’s governing body must have a chief nursing officer who has been in that position at least for 1 year

Chief Nursing Officer must have a Master’s degree Key Features (must already be in place):

Standards for the Nurse Administrators as identified by the American Nurses Association

A confidential feedback system Data collected about the nurse-sensitive quality

indicators Conformity to all state, local, and federal laws

(Westerndorf, 20047)

Structure Chief Nursing Officer (CNO) Magnet Project Coordinator Nursing Directors and Managers Committees to address the Forces of Magnetism

(Nursing staff and other staff members) Process

Timing of application with other activities Coordinating team meetings Completing and submitting application Educating and communicating with staff

(brochures, in-services, and posters)

Online readiness tools from ANCC Organization Self-Assessment for Magnet Readiness (www.ana.org/ancc/magnet/orgready.pdf)

Staff Nurse Self-Assessment to Determine Readiness to Pursue Magnet Recognition (www.ana.org/ancc/magnet/selfassess.pdf)

Consider staff surveys and focus groups such as shared governance.

Develop databases, sources of data and performance results

Cost benefit assessment Consultants to assist with gap analysis and review

documents

Working with other nurses who are clinically competent Good nurse-physician relationships and communication Nurse autonomy and accountability Supportive nurse managers Control over nursing practice and practice environment Support for education (in-service, tuition, continuing

education, etc.) Adequate nurse staffing Concern for the patient is paramount Visibility of Chief Nurse Executive Staff nurse participation in hospital committees

Quality Committee: involves collecting data for participation in the National Database of Nursing Quality Indicators (NDNQI).

Forces of Magnetism committee: provide practice examples and collect supporting evidence from point of care on how Forces are integrated across nursing services and draft written documentation for submission to steering committee/Magnet project coordinator

Education/Marketing committee: develops brochures, posters, and flyers to keep employees aware of projects, writes Magnet update articles for employees and nursing newsletters, educate all members of organization on Magnet, and prepares organization for site visit

Steering committee: leads application process including document submission and site visit, assigns accountability expectations to other committees, evaluates progress, communicates with hospital leader and medical staff, and oversees all committees

Need to be interdisciplinary Should be 8-12 members Majority of members should be Registered Nurses Balance between detailed planners and creative

thinkers Staff nurses can be serve as committee chairs or

share role with member of the nursing leadership team

Include nurse assistants, unit clerks, and LVN’s Magnet project coordinator should serve as

resource

Nursing practice council to address evidence-based policies and procedures, infection, falls, and pressure ulcer rates (data must be collected at the unit level)

nursing education council to address new employee orientation, professional development, ways to increase nursing certifications, and review required competencies for annual competency evaluation

Nursing recruitment and retention council to revise/review staffing and scheduling policies, monitors RN turnover rates and organize recruitment job fairs and retention initiatives, and plan nursing recognition events

Nursing leadership council to plan the budget for nursing resources, participates in the process of clinical ladders and peer/self evaluation, and review patient and nurse satisfaction surveys and recommend practice changes

The purpose of program evaluation is to improve program effectiveness and demonstrate accountability

The more advanced a program is in its implementation, the more complex becomes the program evaluation

Specific purposes of program evaluation are: To determine how various elements of the program interact and

influence program effectiveness To determine the extent to which the mission, goals, and outcomes of

the program are realized To determine whether the program has been implemented as planned To provide a rational for decision making that leads to improved

program effectiveness To identify efficient use of resources that are needed to improve

program quality

Approach to program evaluation can be theory-driven or a model based planning tool

The Logic Model is a planning tool used by program mangers and evaluators to describe the effectiveness of their program

The model describes logical linkages among program resources, activities, outputs, audiences, and short-, intermediate-, and long-term outcomes related to a specific problem or situation.

Logic models are narrative or graphical depiction of processes in real life that communicates the underlying assumptions upon which an activity is expected to lead to a specific result

Magnet Recognized program evaluation is based on global issues in nursing and health care

Program evaluation must begin by determining the appropriate mission, philosophy, program goals, and outcomes have been defined

The Magnet Program advances 3 goals within health care organization Promote quality in a setting that supports professional practice Identify excellence in the delivery of nursing services to

patients/residents Disseminate best practices in nursing services

Program evaluations built solely around accreditation criteria may lack examination of some important elements or understanding of the relationship between elements that influences program success.

Purpose of Magnet recognition: to separate “true magnets from those that simply want to achieve the recognition” (Hughes, 2008).

There are studies that have looked into the relationship of magnet features to patient outcomes

Magnet Recognition creates a structure for an organizational environment conditions that “support and facilitate nursing excellence” (Hughes, 2008).

With the Magnet Recognition, hospitals are able to preserve a staff of well-qualified nurses which in turn results in higher quality of care for patients

Studies show that nurses were more satisfied at Magnet facilities and burn out rates were decreased

Having this recognition shows that these were good places for ALL employees to work as well as a better place for patients to receive care

In essence, improvements are still needed to research magnet features to better enhance requirements

Philosophy of Magnet Status shows that nurses function at their peak when in a Magnet Status environment

Magnet recognition shows “lower burnout, higher satisfaction, and fewer reports of intentions to leave” (Hughes, 2008).

American Nurses Credentialing Center (2014). Magnet Recognition Program Model. Retrieved online at http://www.nursecredentialing.org/Magnet/ProgramOverview/New-Magnet-Model.aspx

Billings, D. M., & Halstead, J. A. (2012). Teaching in nursing: A guide for faculty (4th ed.). St. Louis, MO: Elsevier Saunders.

Hughes , RG (2008). Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville, MD: Agency for Healthcare Research and Quality (US) Chapter 46. Retrieved online at http://www.ncbi.nlm.nih.gov/books/NBK2667/#ch46.r11

Turkel, M. C. (2004). HCPro's Guide to Assessing, Pursuing, and Achieving Excellence in theANCC Magnet Recognition Program. 1st edition. HCPro's, Inc.