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Implementing differentiated practice: personal values and work satisfaction among hospital staff nurses.

This project was part of a collaborative model for nursing staff development and student education. Personal values and work satisfaction of 49 staff nurses working on three hospital units were compared. One of the units employed differentiated practice. Results revealed high similarity in personal values among all nurses. Work satisfaction was significantly higher among nurses working on the unit employing differentiated practice. The importance of assessing personal values of nurses emerged as an important aspect of staff development, and differentiated practice appeared to be related to staff nurse satisfaction.

Adult↗

Preparing preceptors through online education.

Preceptor education is vital to the success of healthcare institutions. Preceptors' roles are complex and require up-to-the-minute programs reflecting crucial mentoring responsibilities for orientees in multifaceted working environments. Finding the time to properly educate preceptors while maintaining quality bedside care is a challenge for staff development educators during the nursing shortage. Offering a preceptor education program online can assist preceptors in the adoption of role changes in a timely manner. The outcome can provide excellent, competent, caring preceptors. In this article, the course content and intended outcomes of online preceptor preparation programs are discussed. The role of the staff development educator in assessing, planning, implementing, and evaluating online preceptor programs is also discussed.

Computer Literacy↗

Bathroom blitz it!

BACKGROUND: Staff development specialists are always looking for new and better ways to get the JCAHO message to their organization's staff. METHOD: The staff development department used a novel method, the Bathroom Blitz, to educate captive audiences, one-person-at-a-time, thereby using the common situation in an uncommon way. RESULTS: Twelve hundred employees had the opportunity to regularly become informed of JCAHO topics without having to leave the unit. CONCLUSION: The Bathroom Blitz approach was an effective tool for educating staff in preparation for the many "mock surveys" conducted prior to Joint Commission and the actual onsite JCAHO visit.

Education, Nursing, Continuing↗

Delphi technique: one cycle of an action research project to improve the pre-registration midwifery curriculum.

Facilitating a unified interpretation of new or re-designed curricula can be problematic in multi-sited universities. This paper discusses the use of the Delphi technique when implementing an innovative pre-registration midwifery curriculum. It formed one of the action research cycles of the author's doctoral study and was used in an attempt to seek the views of all midwife teachers and achieve a critical mass consensus. The most important issues that emerged from the Delphi process were grouped into four categories. These four categories (the teacher's base site, communications, staff development and administration issues) formed the agenda for a staff away day. The outcome of the process was the generation of a list of priorities and actions for curriculum implementation and the identification of ways in which staff development needs might be met more effectively. An unexpected, but equally important, outcome was the way it helped with team building and agreement on positive actions for its further development.

Attitude of Health Personnel↗

An approach to presentation skill development of nurses.

When staff development specialists help nurses gain presentation skills, they benefit by increasing the pool of clinically expert nurses who can share information and ideas. In this article, the authors describe an approach that includes conducting a workshop and providing opportunities for participants to make a presentation. Strategies to enhance presentations and reduce fear are addressed.

Education, Nursing, Continuing↗

A collaborative model for evaluation of clinical preceptorships.

Nurses engaged in practice, recruitment, and staff development were asked to evaluate an educational clinical preceptorship jointly developed by nurse managers and nurse educators. An open-ended six-item questionnaire and a guided telephone interview were used to gather evaluative data. Nursing service respondents valued the precepted clinical experience, not only for the students but for the professional development of the staff participants. The educational clinical preceptorship provided the opportunity for collaboration and the development of collegial relationships between academia and service. An evaluation model evolved that emphasizes the importance of feedback from all participants.

Clinical Competence↗

Unit discharge planning model.

THE UNIT DISCHARGE coordination model was implemented in January 1993 at the Children's Seashore House in Philadelphia, Pennsylvania, a 77-bed inpatient pediatric specialized care and rehabilitation institution. The model, which identifies staff nurses as primary discharge coordinators, has shown remarkable outcomes, evidenced by decreased lengths of stay, improved staff development, and better coordination of discharge resources. CNSs and nursing administrators will find this model cost effective, economically sound, and quality focused to enhance professional development at the staff level.

Humans↗

Application of the critical pathway and integrated case teaching method to nursing orientation.

BACKGROUND: Nursing staff development programs must be responsive to current changes in healthcare. New nursing staff must be prepared to manage continuous change and to function competently in clinical practice. METHOD: The orientation pathway, based on a case management model, is used as a structure for the orientation phase of staff development. The integrated case is incorporated as a teaching strategy in orientation. The integrated case method is based on discussion and analysis of patient situations with emphasis on role modeling and integration of theory and skill. RESULTS: The orientation pathway and integrated case teaching method provide a useful framework for orientation of new staff. Educators, preceptors and orientees find the structure provided by the orientation pathway very useful. CONCLUSION: Orientation that is developed, implemented and evaluated based on a case management model with the use of an orientation pathway and incorporation of an integrated case teaching method provides a standardized structure for orientation of new staff. This approach is designed for the adult learner, promotes conceptual reasoning, and encourages the social and contextual basis for continued learning.

Adult↗

Cross-training for obstetrics using an internship program.

During these changing times in the healthcare environment, staff development and management must work together to provide competent staffing models. This article focuses on an innovative pilot internship program that was developed and implemented collaboratively by the management/staff development team. The article describes a cross-training program for new graduates in obstetrics at a major southeastern university hospital. The article focuses on a present and future opportunity for staff development--"cross-training."

Academic Medical Centers↗

Costing nursing education programs. It's as easy as 1-2-3.

Staff development departments are pressured to reveal the costs of their educational programs and to compete with outside vendors for programming. The process of implementing a spreadsheet template for costing out staff development programs is described. The template is easy to use and supports "what if" analysis. This model allows educators to evaluate cost implications of curricular decisions and to better negotiate with internal and external customers.

Cardiopulmonary Resuscitation↗

Valuing the primary care patient base.

This analysis, albeit limited, can help clinics and integrated health systems with their medical staff planning, and it demonstrates the importance of the primary care patient base as a foundation for health services planning and economic and market strategies. It is important to note, however, that when primary, specialty, subspecialty, surgical, and hospital care are well planned and marketed, it is virtually impossible to identify the relative contribution of each to the overall success of the system. Consequently, primary care physicians should not attribute the value discussed here solely to their efforts. Hospital executives should be mindful of two related issues: First, some administrators remain focused on inpatient services when outpatient services may offer greater economic potential over time. Ambulatory interventional diagnostics and therapeutic procedures (e.g., outpatient surgery) are often undervalued or overlooked in medical staff development plans. The net profits available from additional ambulatory surgical cases can be significant. Second, success in developing a medical staff plan requires more than calculating physician supply and demand ratios. A balance must be struck between meeting the hospital's needs for additional physicians and meeting the needs of the existing medical staff. A number of hospital executives have found that devoting all physician-related resources to recruiting new staff can create resentment among physicians who have remained loyal to their hospitals without financial and other practice incentives and inducements. We encourage multispecialty group practices to become students of primary care development as well and urge them to guard against focusing on the high overhead costs of primary care without recognizing the value of an organized primary care strategy.(ABSTRACT TRUNCATED AT 250 WORDS)

Cost-Benefit Analysis↗

Three decision-making aids: brainstorming, nominal group, and Delphi technique.

The methods of brainstorming, Nominal Group Technique, and the Delphi technique can be important resources for nursing staff development educators who wish to expand their decision-making skills. Staff development educators may find opportunities to use these methods for such tasks as developing courses, setting departmental goals, and forecasting trends for planning purposes. Brainstorming, Nominal Group Technique, and the Delphi technique provide a structured format that helps increase the quantity and quality of participant responses.

Decision Support Techniques↗

Promote recruitment and retention by meeting the unique learning needs of the off shifts.

With the advent of flexible scheduling, the traditional 3-to-11 and 11-to-7 off-shifts can now be defined in a variety of manners. However, generally speaking, the off shift is still considered to be those hospital hours when routine daytime activities have slowed down and evening and nighttime activities are in full swing. The many nurses who are required or elect to work these off-shift hours possess a wide range of learning needs. For a variety of reasons, in many institutions, the number of educational manpower resources considerably diminishes when daytime staff development personnel finish their workday. This article examines the off-shift environment and the nurses who work these shifts as well as proposes methods to meet the learning needs of the off-shift staff. If these learning needs are addressed, staff development efforts can, in fact, become a major professional benefit and recruitment/retention tool for off-shift nurses.

Circadian Rhythm↗

Implementing the Performance Based Development System (PBDS) at Naval Medical Center San Diego.

Competency-based performance development is an educational tool that assesses the knowledge and skill base of an RN to enable staff development personnel to formulate orientation and training specific to that individual's learning needs. Theoretically, competency-based performance development is a time-efficient method for orientation. Recent healthcare reform, budgetary constraints, and downsizing have also affected the military. The stimulus, rationale, and obstacles experienced in implementation of this program in the military are common to all staff development educators.

Clinical Competence↗

An educational fair and poster approach to organization-wide mandatory education.

BACKGROUND: An educational fair and poster approach was developed to meet organization-wide mandatory education requirements. METHOD: A multidisciplinary task force identified 25 mandatory topics. Task force members utilized posters to indicate key points (principles) and questions for each topic. Two interactive stations, body mechanics and fire safety, were developed to allow staff to actively participate and obtain immediate feedback on competency. This educational activity was presented in a fair-like atmosphere continuously over 3 days to reach a majority of staff. RESULTS: Ninety-three percent of the staff attended the educational activity. Department directors received immediate feedback on attendance, test scores, evaluation summaries and problem areas. Post-fair evaluation comments from department directors and staff were very positive. There was a major savings in both staff and staff development work hours. CONCLUSION: An educational fair and poster approach is an efficient method of providing organization-wide mandatory education. This approach can be adapted easily to any organization.

Audiovisual Aids↗

Reflective learning: work groups as learning groups.

Staff development educators are challenged to develop additional learning strategies to meet the demands of the professional nurse in the changing healthcare environment today. Methodology for workplace learning is being developed to meet the critical thinking skills necessary for the professional nurse of the future. This article identifies the use of reflective learning in the workplace and reports outcomes from the implementation of the reflection-on-action technique. The implications for staff development educators are reviewed for the concept of work groups as learning groups.

Education, Nursing, Continuing↗

Strategies to improve the performance of learners in a nursing college. Part II: Issues pertaining to management, attitudes and values.

UNLABELLED: This article forms part two of a bigger study that was conducted in a nursing college to explore and describe the reasons for the poor performance of learners. Part one of the study dealt with the issues pertaining to education, while this article (part two) seeks to describe issues pertaining to management, attitudes and values that lead to the poor performance of learners in the nursing college under study. A qualitative, exploratory and descriptive design that was contextual in nature was employed, and three focus groups interviews were conducted. Seven tutors formed one group while other two groups were formed by fourth-year learners following a comprehensive diploma course. All participants voluntarily participated in the study. Data was analyzed using the descriptive method of open coding in accordance with Tesch's protocol (in Creswell, 1994:154-156). Trustworthiness was ensured using the following principles: credibility, conformability, transferability and dependability (Lincoln & Guba 1985:290-326). Findings were categorized into issues pertaining to management, attitudes and values that had an influence on the poor performance of learners as follows: MANAGEMENT: Inadequate resources and study facilities; policies that change frequently; tutors' dissatisfaction with regard to staff development, the lack of involvement by management and lack of management support, staff shortage and maldistribution of staff members; ineffective selection process of learners; inconsistent regulations, and too many of them; policies and procedures resulting in confusion and poor discipline. Attitudes and values: Tutors' lack of motivation and interest, lack of respect by learners and no team work among tutors. Through a conceptualization process and the recommendations by participants, strategies to improve the learners' performance were described. It is recommended that these strategies be submitted to the staff development committee for implementation and future follow-up research be undertaken to determine the effectiveness of the strategies. It is also recommended that other nursing colleges replicate the study within their context.

Attitude↗