The exemplary professional practice component of the Magnet Model isn't just the establishment of a strong professional, but rather, what that strong professional can achieve. Sparrow Nurses fully understand their role, and how that role relates with patients, the community, and the rest of the Sparrow team.
Professional Practice Model
In May 2011 the newly developed Professional Advancement System (PAS) was introduced. Our professional practice model, the Transformational Model for Professional Practice (TMPP) provides the framework for this three level system. More than 400 nurses applied to participate in the PAS. Over the year, 20 education sessions were provided on how to write a clinical narrative utilizing the TMPP.
Care Delivery Systems
Staffing, Scheduling and Budgeting Process
Sparrow set a goal in 2010 of comparing favorably to other Magnet organizations, measuring in at least the 50th percentile among them. This resulted in increased nursing hours at the bedside and a positive adjustment in the Nurse-to-Patient ratio in many departments.
We adhere to the Centers for Disease Control and Prevention Hand Hygiene Guidelines, including hand hygiene before providing patient care and hand hygiene after glove removal. To measure compliance, stealth monitoring was introduced in 2008. This consists of a trained group of staff that makes 30 observations per month on their assigned unit. Further, we conduct overt monitoring and coaching for non compliance.
Nursing Foundations for Quality of Care
Active staff development or continuing education programs:
- Sparrow Nurses benefited from 88 education programs that provided CEUs in 2011
- 558 Sparrow Nurses participated in our monthly Nurse Enrichment Program
- Our preceptor workshop hosted 62 participants in 2011
- BLS, PALS, and ACLS is offered on-site, as we are now a nationally designated ACLS training provider was introduced in 2011 (computer-based education) High standards of nursing care are expected by administration:
- Our RN to BSN goal of 80 percent of bedside nurses to be BSN prepared by 2020 is based on the Institute of Medicine recommendations. A white paper was developed to articulate these expectations
- Benchmarking Magnet Hospitals and teaching hospitals such as Sparrow is fundamental to our practice, including frequent use of NDNQI data and the Magnet listserve
- Sparrow Nurses are highly encouraged to be nationally certified, with a goal of 60 percent of bedside nurses certified in 2020
Clinical Competency is Fundamental to Nursing Practice
- Competency based orientation is the norm
- Preceptors support and guide the new nurse's orientation
- Our nurse residency is in its 11th year and more than 60 new nurses graduated from the program in 2011
- We initiated our own Critical Care Fellowship in 2011, graduating seven ready-to-practice fellows
Accountability and Leadership
- The Aspiring Nurse Leader program was introduced in 2011. Nurses focusing on developing their leadership skills were invited to a series of five sessions in the spring and fall of 2011. Approximately 50 promising new leaders completed the requirements and about 30 percent acquired a leadership role within the first 12 months.
- The Nursing Practice Review Council began in 2011 whereby full accountability for our practice is discussed, cases reviewed and new expectations implemented by staff members. Examples include constant supervision of high falls risk patients in the bathroom and two RN assessments for skin integrity.
Culture of Safety
Our focus on sustaining a culture of safety at Sparrow has deep roots. Patient-centered care is central to the patient experience and is our primary delivery model. Thus, every action we take is meant to reflect the highest standard of safe practice for the most optimal outcome. We demonstrate this operationally in our nurse-patient ratios; in our bundles of care/protocols (use of bed alarms, hourly rounding and narrating our care, to name a few); and our communications: rounding with physicians, use of SBAR Tool, and bedside shift report. We subscribe to national and state initiatives to perfect our practice, including The Institute for Healthcare Improvement, The Advisory Board Company, Michigan Hospital Association Keystone and much, much more. We use the Plan-Do-Check-Act (PDCA) model to continuously improve our processes that impact excellent, efficient and affordable care. As nurses, we take seriously our role in ensuring only the best outcomes through the Sparrow Way: defining, documenting, deploying and adhering to patient-centered, evidence-based, best practices (clinical, service and leadership) to reduce unjustified process variation throughout Sparrow and deliver national benchmark level outcomes on a consistent and sustainable basis.