OO6

OO6 The learner assessment of the continuing education needs for nurses at all levels and settings, and the related education implementation plan.

Levels of Nurses in OO10

CNO
Director and Assistant Vice President of Nursing
Manager
Patient Care Supervisor
Clinical Nurse Specialist
Clinical Nurse Educator
Clinical Nurses

Learner Assessment of Continuing Education (CE) Needs

For the purposes of learner assessment of CE needs, the Homestead Hospital nursing staff was divided into 2 major categories:

Clinical Nurses
Nurse Leaders (composed of CNO and Assistant Vice President of Nursing, Director, Manager, Patient Care Supervisor, Clinical Nurse Educators, Clinical Nurse Specialist)

*Note: As of the time of writing, Homestead Hospital did not hire advanced practice nurses (ARNP). They were employed by physician groups that were contracted by the hospital. And as such, their continuing education needs were overseen by the Baptist Health Continuing Medical Education (CME) department.

Content experts from Clinical Learning, Human Resource (HR), Organizational Development (OD), and Magnet Designation departments collaborated in developing the survey instrument. Clinical nurse educators (CNE) from each nursing unit conducted the learner assessment. They used the same tool to survey nurses across all levels. The CNES administered it in a slightly different manner. They felt that the nurses have been bombarded with a lot of surveys already and would not be enthusiastic in responding to yet another survey request. Instead of using the typical online or handwritten survey, they decided to carry out a “flip chart” survey. They thought that this method would be more interactive and fun.

The survey consisted of 6 questions: 4 multiple choice and 2 open-ended. The CNEs wrote the survey questions on flip charts and created 2 sets, one for clinical nurses and another for nurse leaders. They carried out the assessments at the end of staff meetings to promote participation. They provided nurses with 4 dots to place next to their selected response for questions 1 to 4 and markers to write in answers for questions 5 and 6. (OO6 01 Survey Instrument)

The learning needs survey was conducted over the entire month of January 2013. CNEs turned in the results to the Magnet Designation department for collating. A total of 332 (74%) nurses participated. (OO6 02 Learner Needs Assessment Hospital-wide Results)

Results and Implementation Plan

Clinical Nurses

According to the survey, clinical nurses (N=284) indicated that their preferred way of learning was the classroom setting (52%), followed by computer based-training (37%). Their preferred length of time for classes was 1 ½ -2 hours (38%).

Professional Topics - The top 3 professional topics identified by the clinical nurses were applying evidence-based practice (EBP); professional development; and performance improvement (PI). Corporate Clinical Learning Clinical Educator Regina Russell, MSN, MBA, RN, RN-BC evaluated the programs offered in Baptist Health University (BHU) in relation to these identified learning needs. She noted that several ongoing online and live classes with continuing education units (CEU) already existed as shown in the table below (not an inclusive list). Thus, the implementation plan for this category would involve increasing nurses’ awareness of their availability through targeted marketing.

Name of Module	CE Broker #	Contact Hours
EBP
Anticoagulant Therapy in Neonates	20-256714	1.0
Best Evidenced-Based Stroke Practices Online	20-292904	4.5
Epidural Analgesia Self-Study	20-45993	2.0
Improving Care at End of Life: Essential Issues	20-26293	2.0
Intercultural Palliative Care/End-of-Life Online Training for RN-Required Modules	20-395442	5.0
Patient and Family Education for a Diverse Population	20-236096	2.0
Promoting a Culture of Patient Safety	20-7256	2.0
Ten Steps to Evidence-based Breastfeeding: Part I – IV (20-439668; 20-441466; 20-441483)	20-443698	16.0
Professional Development
Leadership Skills for the RN	20-275866	4.0
Nurse in Charge Class	20-217684	4.0
Nursing Leadership Institute Series Part 1 (12 Sessions)	20-455634	6.0
PI
Introduction to Performance Improvement - Computer Based	20-227283	4.0

Leadership Topics – Clinical nurses indicated wanting to know more about communication; dealing with conflict; giving and receiving feedback; and competency-based leadership. Senior Onboarding and Employee Development Specialist Deana Naraine reviewed leadership topics offered to front-life staff in light of the survey results. There were already existing instructor–led classes pertaining to these topics. However, these classes do not offer CEUs yet. Therefore, the implementation plan would be to explore if CEUs can be applied for these programs. Furthermore, clinical nurses could also access these leadership and other development topics in SkillSoft, a premier provider of online learning and e-learning solutions.

Topics	Purpose
The Art of Communicating	Provides the basics of communication and why it is important to communicate effectively.
Understanding Your Communication Style	Develops and strengthens skills of the staff in order to improve communication, build positive relationships and maximize team effectiveness through open dialogue, group exercises and teambuilding initiatives in order to positively affect patient satisfaction, employee engagement and physician relationships.
Assert Yourself	Designed for those who wish to improve their ability to communicate with people at all levels. Offers participants a range of assertive techniques that will give them the confidence to achieve what they want in different workplace situations.
Conclict Managment - Handling Difficult People with Ease	Presents strategies for handling interpersonal tension in the workplace.
Creating Harmony in the Workplace - Trust Building	Provides tools to work with others to achieve strategic and purposeful outcomes; and create harmony, trust and stability among fellow workers
Dealing with Difficult People	Gives employees techniques and strategies on how to diffuse anger and regain customer goodwill with ease and confidence
Giving and Receiving Feedback	Helps improve employee skills in giving both types of feedback and receiving feedback in return.
Emotional Intelligence	Assists staff in developing and recognizing emotions; understand them; and realizing how emotions affect people around them.
Employee Engagement 101	Provides employees with an overview of employee engagement, its impact, measurement, and the key components that help drive and sustain it.
Positive Work Environment	Enables staff to apply methods of overcoming a negative work environment and creating a positive work environment.
Stress Management	Helps employees understand and manage personal and professional stress.
Creating a Culture of Personal Discipline: Time Management in the 21st Century	Assists employees in managing their time more effectively; avoiding time wasters; and goal setting to accomplish tasks.

Clinical Topics - Clinical nurses had an opportunity to specify their areas of interest by writing them down on the flip charts. Furthermore, there was another open-ended question labeled “Others” for them to indicate any other topics of interest. The results showed a wide variation of subject matters in their responses, which were largely dependent on their area of specialty. For example, sepsis screening, management, and detection was asked for in ICU/PCU while EKG interpretation was a predominant request in MS5, a medical-surgical telemetry unit.

CNEs met and discussed the results of the survey. Their goal was to identify topics that were common throughout departments such as documentation and use them as topics for the annual Team Training session. Team Training is a 3-hour education event for which clinical nurses were required to attend yearly. It had been used to conduct mock-codes and provide in-services on hospital policies and procedures relevant to nursing. These sessions did not offer CEUs. For specialty-based topics that may not be so common throughout other nursing departments, their plan was to direct clinical nurses to existing classes available in BHU and/or provide them with education by developing learning events in their specific specialties. For example, classes were already available in BHU on EKG for initial, basic and advanced instructor-led classes. Marketing of these classes could be increased to improve clinical nurses’ awareness of their availability. In the Perinatal specialty, DIC-HELLP was a topic of interest. There were no classes in BHU on this subject. Thus, the plan would be for content experts in this specialty to develop a learning event with CEUs offered.

Additionally, CNEs planned that during Team Training an optional class will be offered in the final hour. This class would address topics identified in the survey and would offer CEU. They also planned tailoring the quarterly Nursing Grand Rounds to include clinical topics identified in the survey. The online journal club could also be a venue for addressing these topics especially that there was already a system in place for offering CEUs.

Nurse Leaders

The survey results showed that nurse leaders (N=48) identified computer-based training (74%) and classroom setting (63%) as their preferred way of learning. Over 60% of leaders preferred training sessions lasting between 3-4 hours. Another 36%-38% reported a preference for shorter training sessions lasting between 1-2 hours.

Professional Topics - The top 4 professional topics identified by the nurse leaders were applying evidence-based practice (EBP); PI; practice standards; and data analysis competencies. Some subjects identified by this group were similar to that of the clinical nurses and thus the implementation plan would be the same as described above. In addition, data analyst from the PI department could assist nurse leaders with data analysis. There was also a recently approved position for a Statistician in the Magnet Designation department. Part of this person’s responsibilities would be teaching leaders and staff with data management. With regards to the practice standard learning needs, Clinical Learning previously offered a class ““It’s Your License – How to Honor and Protect Your License” that discussed application of practice standards such as the Nurse Practice Act; American Nurses’ Association (ANA) Code of Ethics; and Nursing Scope and Standards of Practice. Additional sessions could be offered on this particular class to address this learning need.

Leadership Topics - A team of OD consultants under corporate HR focuses on leadership development. In Homestead Hospital, Senior OD Consultant Aleister Avila oversaw this function. He had a direct reporting relationship to the HR Site Director and an indirect reporting relationship to the corporate Director of Leadership Development and Talent Management. Nurse leaders indicated wanting to learn more on giving and receiving feedback; dealing with conflict; and competency-based leadership. Leadership programs currently offered at Homestead Hospital and at the system level already addressed many of the needs identified by the survey. For example, the main leadership offerings called “Leadership, the Baptist Health Way” and “The Frontline Leader” were competency-based training programs. Topics in these programs included giving feedback and effective communication to build trust and influence. Other leadership workshops such as “Evidence-based Selection” included interviewing skills. Most of these leadership classes were offered in a classroom setting and some were blended learning which encompassed computer-based training and online resources. In addition, other leadership classes were offered online through BHU and SkillSoft. Implementation plan would explore if CEUs can be offered for some of these programs. Below is a description of leadership development courses offered recently to Homestead Hospital leaders and nurse leaders:

Topics	Description
Leadership Baptist Health Way	This is a series of 6 leadership workshops that cover leadership foundational skills on self awareness, influence, and motivation. These classes last between 2 to 3 hours and are available for all leadership levels Creating Powerful Coaching and Feedback Conversations: Coach for maximum impact. Develop your key talent. Connect with your employees' career and developmental needs. Knowing Yourself as a Leader: Understand the difference between leading and managing. Increase awareness of your leadership style. Integrate your personal values with organizational values to impact your leadership. Use your leadership style effectively. Managing Vision and Purpose: Link the company's mission/vision to departmental/individual objectives. Hold your team accountable. Manage a heavy workload. Using Your Influence to Lead Your People: Identify your influencing style. Become an effective influencer. Embrace change as a leader. Overcome resistance to change. Communicating to Build Trust: Communicate to build positivity in the workplace. Communicate to build trust. Communicate to manage relationships. Communicate change positively and gain buy in. Managing Performance: Identify and coach low performers Understand how to address poor performance through the corrective action process Recognize the importance of effective documentation
The Frontline Leader	This curriculum combines group and individual learning experiences through 90 minute sessions, called “Power Hours” with web-based resources. Each workshop will address current business trends with at least 45% of the time devoted to “real-time” leadership challenges. The program takes place over the course of nine months. It includes approximately: 12 days of 90 minute discussion groups (Power Hour Sessions) 10 days of individual work (pre-work, assignments & readings) Program Audience: Newly hired supervisors or managers Leaders who are recently promoted to a supervisory or a managerial role and have never had any exposure to training and development.
Evidence-Based Selection: Interviewing The Baptist Health Way	This workshop focuses on increasing the ability to hire the best talent by learning how to interview and evaluate candidates effectively. Attention is placed on the STAR methodology and asking the right probing questions. This course includes an online module to be completed prior to the live session and is geared for all leadership levels.
Retaining Talent 101	This session helps leaders analyze and manage employee turnover in their departments. Tools and resources are provided to help leaders understand why employees leave, why they stay, and how to apply practical retention strategies in order to retain talent.This course is a live session for all leaders.
Engagement 101	This course will define employee engagement, and identify the impact of employee engagement on leaders, employees, and the organization. At the conclusion, participants should be able to understand how employee engagement is measured, and identify the key drivers of employee engagement. Leaders will also be able to identify the next steps in Baptist Health's roadmap to engagement.
Leader Engagement Forums	Interactive forums offered by Homestead Hospital executives and engagement champions to share engagement best practices, respond to leader challenges in building & sustaining engagement and initiate mentoring partnerships.
Employee Core Competency Overview	The employee core competency model is reviewed. During this session leaders learn the employee competency model and how to assist employees in their professional development.
Having Development Conversations	The purpose of this workshop is to prepare leaders in conducting effective development conversations and create compelling development plans using the new core competencies. At the conclusion, participants should be able to: Apply the five steps of developing employee competencies. Conduct effective development conversations. Co-create compelling development conversation. Use the development tools effectively.
Good to Great	This course is for promoted or newly hired leaders at Homestead Hospital. The course teaches participants to understand the three basic concepts of the book 'Good to Great' 1) Disciplined People 2) Disciplined Thought 3) Disciplined Action. At the conclusion, participants should be able to: Apply leadership best practices Understand the three basic concepts of the book ‘Good to Great’: disciplined people, disciplined thought and disciplined action Write employee thank you notes effectively Conduct rounding sessions with staff Facilitate 30, 60, 90 day evaluations with new hires
Individual Development Plan (IDP) Workshop	This workshop prepares leaders to conduct career development discussions with their leaders and create compelling individual developments plans. At the conclusion, participants should be able to: Identify individual career goals Assess your areas of strength and development Brainstorm development opportunities Draft your individual development plan (IDP) Partner with your leader and entity development facilitator to achieve your development goals Locate additional resources for support
New Leader HR Orientation	This session is for new leaders and focuses on providing just-in-time education on HR issues leaders typically encounter early in their tenure. Topics presented include: Role of HR Site Management Leaves of Absence Americans with Disabilities Act (ADA) Recruitment Process Performance Evaluations Coaching and Corrective Actions Leadership Evaluation Management (LEM)
New Leader Orientation	This essential orientation provides newly hired and promoted leaders across Baptist Health with a global understanding of the organization’s mission, vision and strategies to produce success in the areas of clinical and service excellence, workforce development, long-term financial viability and community benefit. Topics presented include Baptist Health’s: Mission, vision, values, strategies, pillars of success and financial state. Leadership philosophy and leadership best practices. Culture of patient safety, patient and family centered care and patient satisfaction Resources for leaders and staff
Leadership Development Institutes	One-day leadership development sessions where we educate leaders and enhance the skills they need to drive organizational outcomes and improve their own individual leadership performance. Recent LDIs included the following topics: March 2014: High Reliability Organization: Creating a Culture that Drives Performance. October 2013: Obamacare Boot Camp April, 2013: Leading Change: Developing an Engaged Team/Culture. October 2012: Developing Our Talent.

Clinical Topics – There was again a spectrum of clinical topics identified in the open-ended survey. The results and corresponding implementation plan were very similar to that of the clinical nurses as described in section A3 above.

Summary

Homestead Hospital and Baptist Health South Florida (BHSF) place a high priority on the education and training of nurses and staff. They have put in place structures and procesees to assess learner CE needs and dedicated resources to address identified needs. Previously, Clinical Learning provided American Nurses Credentialing Center (ANCC) continuing nursing education as approved providers under the guidance of the Georgia Nurses Association. In October 2013, corporate BHSF has achieved accreditation from ANCC as a provider of continuing nursing education by demonstrating excellence in educational design, delivery, and outcomes. This allows nurses to earn ANCC-approved CE credits by participating in BHSF educational activities. Majority of these educational offerings are provided on-site or via computer-based training at no cost to the nurses. (OO6 03 2014 ANCC-Approved Classes) Russell serves as the designated nurse planner for the BHSF provider unit and chairs the Continuing Education Council at the system-wide level.

Summary of Attachments/Hyperlinks/Evidences

OO6 01 Survey Instrument
OO6 02 Learner Needs Assessment Hospital-wide Results
OO6 03 2014 ANCC-Approved Classes

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Structural Empowerment