1. More On Integration Tips and Tools November 21, 2008 Eliette Allec, Jane MacDonald, Karen Schnell-Hoehn, Joanne Major, Cindy Holland, Cathy Gillespie, Anne Marie Brown

2. Outline Background Information Literature Review APN Toolkits Orientation Guideline CNS & NP Learning Needs Assessment Tools Pilot Implementation Next Steps Discussion

3. Background Nursing Leadership identified need Brought to WRHA APN Steering Committee Sub-committee established Development of Orientation Guideline & Learning Needs Assessment Tools Recognition of importance of mentoring Feedback elicited

4. Literature Review of literature to look for learning needs, tools & barriers Limited literature Bryant-Lukosius & DiCenso - PEPPA Framework to implement and evaluate roles (2004) Forbes et al. tool to support professional development (2006)

5. AuthorsYear Summary Learning Needs Bamford & Gibson2000Grounded theory looked at CNS role & development needs in 2 acute hospitals in UK. Used focus groups & identified on novice to expert continuum. Tailored Orientation, course re: clinical specialist skills, research skills, time management, publishing, contracting & business planning Bass, Rabbett & Siskind 1993Use of Benner model to explore transition from experienced staff nurse to novice CNS Expectations & responsibilities of new role, how to be a consultant, how to effectively teach other staff, clinical knowledge & skills, how to work with unit manager, effective communication with staff Cusson & Viggiano 2002Discussion of transition from expert neonatal nurse to Neonatal NP Advanced communication & collaboration skills, clinical management & technical skills Glen & Waddington 1998Case study exploration of the role transition of 2 staff nurses to clinical nurse specialists Clinical knowledge & skills, Organizational socialization (organization’s structure & culture & how to work effectively within it), Stress management Jones2005Meta-synthesis of qualitative research reporting barriers or facilitators to role development and/or effective practice in specialist and advanced nursing roles in acute care hospital settings. Skills for marketing the role, conflict resolution skills, political astuteness, clinical skills & knowledge, change management skills Krcmar1991Examination of factors impacting on organizational entry of the CNS Organizational socialization e.g. key players, people management skills e.g.. delegation Martin1999Description of the evolution of the role of transplant advanced practice nurse at one institution. Opportunity to improve clinical skills

6. APN Toolkits Guide to the Implementation of the NP/CNS Role Developed by APN Regional Steering Committee Specific Toolkit for NP & CNS Purpose – to provide information on APN roles, tools & strategies for implementation

7. Toolkit Contents Needs Assessment  identify population & most appropriate practitioner Site Readiness  legislation, liability, space & beliefs/goals (culture) Human Resource Issues  leadership, provider receptiveness, consumer readiness, recruitment/retention, communication, group collaboration

8. Toolkit Contents Practice  collaboration, scope, standards, Strong Model, role clarity, practice development Support Structures  admin support, billing, info management, regional policies Evaluation  (under development) satisfaction, efficiencies, economic analysis, outcomes

9. Appendices Job Descriptions Needs Assessment Example Primary Care Equipment List Examples of Interview Questions Sample Budget Template Primary Care Cost Analysis

11. WPH & S PHIA/FIPPA Facility Fire Extinguisher Documentation New Advanced Practice Nurse Orientation NP CNS Meet with Manager/Director Receive and discuss Competency Based Learning Needs Assessment Tool Review Strong Model document and article on mentorship Discuss potential mentor (NP/CNS) Schedule follow-up meeting Reassess with Manager and Mentor at 3 months/6 months/1 year Performance Appraisal Follow-up Meeting with Manager/Director Develop learning plan based on completed Learning Needs Assessment Tool and unique requirements of population served Determine action steps and timelines Identify primary mentor

12. Learning Needs Assessment Tools Separate tool for CNS & NP Based on: –Strong Model –WRHA APN Job Descriptions –EP competencies for NP

13. Background New but not new Mentorship by previous CNS Established communication with Program Director

14. Using the Tool CNS learning needs assessment completed Focus and prioritizing Opportunity and resources Mentor

15. Educational Plan Research competencies Direct Comprehensive care Education Leadership Support of Systems

16. Feedback on the Tool Focused conversation Provided structure to learning needs Created efficiencies Established a beginning...

17. Next Steps Implementation Process Promote use of the tools Development of Performance Appraisal Tools