1. Understanding VPNPP Advancement
Christy Mullen, MSN, RN, CPN
Kelly Ernst, MSN, RN-BC
Nicole Arnett, BS

2. Objectives Discuss the overall goals of VPNPP.
Describe the 4 levels of nursing care as defined through VPNPP.
Identify the steps involved in RN/LPN advancement.
Identify resources to better understand VPNPP and the advancement process.
Here are the objectives for our presentation

3. Vanderbilt Professional Nursing Practice Program
Performance-based career advancement program for both RNs and LPNs.
Utilizes self, peer, and manager evaluations to recognize and reward clinical nursing expertise in direct patient care
Supports growth within the role of professional nurse.
What is VPNPP?

4. Program Goals Levels of Practice
Understanding VPNPP
Program Goals
Levels of Practice

5. Goals of VPNPP Attract and retain nurses
“Employer of Choice” in the community
Reward nursing performance
Provide opportunities for promotion
Achieve consistent nursing performance standards and pay equity
Build a Performance Development System that promotes, supports, recognizes, and rewards nurses
Attract and retain clinical nurses in direct patient care
Position Vanderbilt to be the “Employer of Choice” in the community
Reward nursing performance in accordance with indicators of clinical expertise and contribution to the team, the work area, and the organization.
Provide opportunities for promotion for nurses in the practice of direct patient care
Achieve consistent nursing performance standards and pay equity across the clinical enterprise
Build a Performance Development System that promotes, supports, recognizes, and rewards nurses for the work that they do every day

6. Novice to Expert Level 1 – Novice Level 2 – Competent
RN/LPN with less than 12 months of clinical nursing experience.
Level 2 – Competent
RN/LPN with more than 12 months of clinical nursing experience.
All nurses are required to attain and maintain practice at this level.
Level 3 – Proficient
This group consists of nurses who participate in continued self-education, changing unit or organizational processes
Level 4 – Expert
This group consists of nurses who lead and evaluate unit and organizational process changes using evidence as a guide for change.
All direct care nurses participate in VPNPP at one of four levels.
Benner describes competent as a nurse who uses experience based practical knowledge to apply this information appropriately and efficiently while mindful of goals.
Proficient- This RN/LPN has achieved a global “big picture” perspective, attends to total situation, proactive
Expert is a nurse who has highly skilled performance intuitively knowing what to do and expected results.
(Refer to handouts for additional qualities of each level of nurse)

7. VPNPP Advancement Process
The Four Phases

8. Phase One- The Conversation
Discussion of advancement—
Could be initiated by either staff nurse or Manager
Leader: Review letter and candidate’s appropriateness for advancement
Step 1: Candidate letter of intent to manager - complete the "candidate letter of intent to manager" and submit it to your manager.
Step 2: Manager response - return letter of intent. The manager has two weeks to review and reply to you regarding your application intent.
Steps 1 and 2 should take no longer than 2 weeks
Step 3: Manager and nurse meet regarding what information is needed from whom and when (meet within 2 weeks) • If YES - Manager supports advancement without reservation; sets date for evaluation completion • If NO - Manager and nurse meet to create development plan to meet specifically defined requirements for successful advancement. Set date for check in (3 month max).

9. Phase Two- Advancement Evaluation Package
Manager assigns an advancement evaluation package or changes prior year’s annual evaluation to an advancement evaluation
Advancement Package includes: Self, Peers and a manager evaluation, VPES scores as well as the Advancement questions
RN completes the “Advancement questions.”
Advancement to RN/LPN 4 requires completion of “Healthcare Endorsement Form.”
Step 4: Unit Manager will either 1) change prior year's annual evaluation package to an advancement evaluation package in the VPNPP online evaluation system or 2) create and assign new advancement evaluation package. All evaluators have a maximum limit of six months to complete the assigned advancement tool. 
Step 5: Manager reviews all completed evaluations to ensure eligibility for advancement (1 week max). Applicant prepares for "the interview" by reviewing and preparing answers for an advocacy review session (formerly known as the interview).  Click here for Pillar-Based Advancement Questions.
Step 6: Unit Manager and a member of Steering Committee debriefs 2 peers (See VPNPP Resources tab for list of Steering Committee members). This step may be omitted if the manager has completed the advancement process for 3 or more nurses within the last 12 months.
All advancement related evaluations and documentation audits must be labeled as "COMPLETED" in the VPNPP Online Evaluation System before progressing to Phase 3.

10. Phase Three: Final Advancement Package
When following have been completed:
Evaluations finalized in the VPNPP system
VPES scores are complete
Answers to interview questions completed
Healthcare Team Endorsement form (PRN)
Submit on-line “Advancement Application form.”
A confirmation of receipt will be sent when the application is received
Step 7: When the above steps are complete (the advancement application is finalized in the VPNPP system, VPES scores are complete, and peers have been debriefed), submit online advancement application form. Complete instructions on form to complete portfolio. 
Step 8: Confirmation of portfolio receipt is automatically  ed to applicant. Please contact Nicole Arnett (VPNPP Program Coordinator) with questions about package submission.

11. What makes an Advancement Packet Complete??
Manager Evaluation*
Self Evaluation*
Peer Evaluation* (two individual evaluations or if a group peer was performed the names need to be listed in the “Collaborated With” box)
VPES Scores
Interview Questions
Health Care Team Endorsement (level 4 only)
*all evaluations need to be in the “Completed” status

12. Phase Four: Advocacy Team Review and Presentation
Advocacy Review Session
Presentation of Candidate by Advocacy Team
Central Committee Endorsement for Advancement
Step 9: Advocacy Review Session - the Advocacy Team includes a practicing level 3 or 4 staff nurse and either a member of nursing leadership or a nurse with a Master's Degree in Nursing. Applicant's will have selected either the 2nd or 4th Thursday of an upcoming month when they would like to meet with the advocacy team.
After the interview, advocate team will present candidate at an upcoming Central Committee meeting..
Step 10: CC endorsement for advancement will be submitted to the Executive Chief Nursing Officer
Advocate team calls candidate within 24 hours
Letters signed by the Executive Chief Nursing Officer (Marilyn Dubree) will be mailed to candidate's home
VPNPP program coordinator will send an advancement notice to manager at a minimum of 1 week after the candidate successfully advances

13. Resources www.vanderbiltnursing.com Observe VPNPP Central Committee
questions to
Policy # CL

14. Thank you from the VPNPP Leadership Team:
Nicole Arnett
Kelly Ernst
Christy Mullen