Understanding VPNPP Scoring Descriptors Nursing Education and Professional Development VPNPP Leadership Team vpnpp@vanderbilt.edu

Purpose and Outcomes 1. Completing this presentation will assist staff nurses [or nurse leaders] in understanding the VPNPP scoring descriptors 2. Participants who complete this presentation will be able to: Describe the two domains that are evaluated List examples for each scoring descriptor

Theoretical Background for VPNPP VPNPP is based on a framework described by Patricia Benner in her seminal work, “From Novice to Expert”. Benner’s framework is based on Skill Acquisition Theory described by Dreyfus and Dreyfus in the 1970s. The theorists proposed that skill development occurs in stages with predictable, identifiable behaviors within each stage Benner’s work focused on describing these developmental behaviors in terms of nurses’ work. Benner describes 5 levels of practice based on this framework: Novice Advanced Beginner Competent (RN/LPN 2) Proficient (RN/LPN 3) Expert (RN/LPN 4) 

Effect on Team Quality/Expertise Domains Evaluated Effect on Team Quality/Expertise

Understanding Effect on Team Domain 8 behavioral measurements for effect on team domain Users of the VPNPP system should focus on selecting a specific behavioral measurement that most closely relates to the work being described in the provided example

Understanding Descriptors related to Effect on Team Domain What descriptor says. . . Behavior that descriptor portrays. . . Unaware or ignores standards and/or directions (***Nursing leaders will immediately address such performance and not wait for an evaluation) •Behaviors that meet this descriptor are usually described as “unsafe” by most nurses. •These behaviors include consistently not following organizational and/or professional policies and standards Requires much direction •Behaviors that meet this descriptor include an inability to organize workload, make decisions, and/or prioritize work •May also be seen as a lack of confidence to perform without help Requires some support (***If selected for a nurse resident or level 1 nurse, will not result in a criteria score less than 3 because it is appropriate for those nurses to require some support) •Best used to describe behaviors where nurses need consistent consultation or support from more experienced nurses after orientation –these behaviors are equivalent to what would be expected of a new nurse within the first year •This descriptor is not intended to describe those situations where nurses occasionally confer with other nurses or health care team members

Behavior that descriptor portrays. . . Descriptors related to Team Domain (cont’d) What descriptor says. . . Behavior that descriptor portrays. . . Independent (*** The majority of specific criteria for level 2 nurses are scored as independent) Nurses scored at this level generally perform care without assistance but may use assistance from peers or charge nurses during complex and emergent situations Role Model & Resource to Others (*** This selection is most often seen in peer evaluations, which is one of the reasons peer evaluations are so important during annual and advancement evaluations) •Role Models exhibit positive examples for others to attempt to follow •Resource nurses demonstrate knowledge and expertise that others recognize and seek out (outside the preceptor relationship) •A resources’ personal behavior demonstrates interest in sharing their knowledge and expertise with others

Behavior that descriptor portrays. . . Descriptors related to Team Domain (cont’d) What descriptor says. . . Behavior that descriptor portrays. . . Initiates Informal Coaching (*** Informal coaching is more than telling someone they are doing something wrong and providing corrective suggestions. *** Informal coaches use questions to prompt critical thinking allowing the team member an opportunity to explore their own practice. Informal coaches facilitate the conversation based on their understanding of the evidence.) Nurses’ whose behavior meet this descriptor: •Take opportunities to share their expertise with the intention of facilitating another’s professional development •Do not wait until asked (like resource nurses) –informal coaches see a situation and coach spontaneously •This process is accomplished by prompting critical thinking and occurs randomly Facilitates Improved Group Practice (*** These nurses’ focus have expanded from 1:1 coaching to include considerations of improving practice among a peer group. *** Examples have included narratives describing the development of educational posters or sending group emails relating to evidence that enhance practice.) Nurses’ whose performance meets this descriptor are improving the practice of the group’s performance. These improvements are commonly described through: Inservices Posters Group Email Standard or Protocol Development Debriefing a critical incident

Behavior that descriptor portrays. . . Descriptors related to Team Domain (cont’d) What descriptor says. . . Behavior that descriptor portrays. . . Formally mentors individuals or groups Two levels of mentoring meet this descriptor: 1.Individual mentoring –is an active, personal relationship by mutual agreement focused on one person providing information, training, or support for one other person to meet specific personal and/or professional goals 2.Group mentoring –is an active, professional relationship by mutual agreement with leadership focused on one person providing information , training, or support to a group of peers to meet specific operational or clinical goals (Examples: nurses who complete chart rounds, competency training, policy review and/or revision, pathway development, area super-user)

Summary of Effect on Team Domain The more engaged and involved a nurse is in supporting peer development, the higher the overall score can be. RN-2 and LPN-2 do what is expected, meet standards, and demonstrate consistent performance RN-3 and LPN-3 participate in unit activities and initiatives and can use “I-statements” such as “I participated in…” or “I did…” RN-4 and LPN-4 lead and evaluate processes or projects intended to validate or improve the overall quality of nursing care and can demonstrate how they have collected and evaluated data pertinent to the process or project ALL Effect on Team Domain scores are applicable to every RN and LPN level.

Understanding the Quality Domain The Quality Doman is solidly based on Benner’s framework, “From Novice to Expert.” There are 5 scoring options, however, the last three descriptors in the Quality domain include competent, proficient, and expert as descriptors of quality practice. It is important to understand how the terms are defined and which behaviors are exhibited at each level so that the appropriate choice is based on performance.

Scoring Options in the Quality Domain What descriptor says. . . This descriptor indicates. . . Does not perform The evaluator is indicating that the criteria being evaluated is consistently not performed Performs inconsistently or not to standard The evaluator is indicating consistent variability in practice ranging from meeting standards to not meeting standards Competent The evaluator is indicating that the nurse being evaluated: Uses experience-based practical knowledge appropriately Provides good care for any patient in the area Is able to identify and address patients needs and issues, is aware of basic resources, and is able to independently collaborate with members of the health care team

Scoring Options in the Quality Domain (cont’d) What descriptor says. . . This descriptor indicates. . . Proficient (*** Situations reflective of this option include those times when the nurse being evaluated is sought out by other competent nurses for support) The evaluator is indicating that the nurse being evaluated: Has achieved a global “big picture” perspective Anticipates potential needs and issues and performs proactively to resolve Is comfortable with their own assignment, and is able to assess the unit’s and peers’ needs and be more available to assist Serves as a resource to others in complex and emergent situations Expert Has highly skilled performance Intuitively knows what to do and the expected results There are “shades of gray” differences between proficient and expert quality scores with the expert being a stronger, more confident advocate who is able to pick up subtle cues regarding patient care or organizational issues

Key Points of Scoring Each domain should be considered separately in relation to the specific criteria being evaluated. The scores from the two domains are not combined. One score relates to the Effect on Team Domain –this is beyond the Credo and describes how the nurse being evaluated effects the team dynamic for each criteria under a key function. The other score relates to the Quality Domain where each criteria is based on how well the nurse being evaluated meets each measure. The final VPNPP Key Function score is a combination of the two domain scores

Once the candidate is scored. . . After the VPNPP system calculates the key function and overall score, the scores are imported into the Vanderbilt Performance Evaluation System (VPES). Examples provided in VPNPP will need to be copied and pasted into VPES, typed into VPES, or can be listed as “see VPNPP tool.”

Scores can be imported from VPNPP by clicking in the Upper right hand corner: ‘Get VPNPP Scores’

The import box will first provide a comparison of information from VPNPP to VPES for the staff member. You will need to verify that this information is correct and matches between systems. VPNPP Name/ID/Job Code VPES Name/ID/Job Code

After verifying the Key Functions, Key Function Scores, and Validation Method to finish the import, just Click on the ‘Import’ button