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Running head: COMMUNITY HOSPITAL CLINICAL PRACTICUM II

Community Hospital Clinical Practicum II

Michael D. Czechowskyj

Ferris State University

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COMMUNITY HOSPITAL CLINICAL PRACTICUM II

Abstract

The nursing profession continues to evolve. The standards for nursing practice are being

elevated and enhanced. Nursing administrators need to evolve too and obtaining a

graduate degree is one way to do this. To be successful in obtaining this degree a strong

clinical practicum must be developed and well executed. The following proposal outlines

a strong plan that will help the learner achieve their goals of being a successful nurse

administrator. The learner will follow the proposed plan and use the literature review and

evaluation tool to support their work and guide the preceptor. At completion of this

clinical the learner will have a strong foundation in nursing administration.

Keyword: clinical, nursing administration, evaluation, plan

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Community Hospital Clinical Practicum II

The purpose of this proposal is to help direct the learner in their clinical practicum

in the community hospital setting. In this setting, the learner will work on core

competencies related to nursing administration and how to put those competencies into

practice. The learner will work with the Chief Nursing Officer (CNO) who will help

direct him while he learns the new nursing setting, how to run a hospital, and how to lead

nurses to success. The CNO already has a good understanding of the core competencies

related to nursing administrations and therefore the best resource for the learner. The

learner has aspirations to be a CNO. Learning from an established and successful leader

will help develop a strong leader and future nurse administrator. The rest of this proposal

will outline the learning plan, a literature review related to nursing administration in the

community hospital setting, a clear description of the facilities, how the CNO will

facilitate learning, and the evaluation tool used to make sure the core competencies are

met.

Learning Plan

The learning plan clearly outlines the core competencies that need to be addressed

by the learner (see Appendix A learning plan). The learning plan was developed to focus

the learner on core competencies in nursing administration that he is not proficient

performing. The four main competencies the learner will work on are, education,

collegiality, research, and resource utilization. Each of these competencies has desired

outcomes associated with them. The outcomes also have expected resources needed to

successfully learn each competency.

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The core competency of education has two areas the learner will focus on. The

first area is how the learner will acquire the knowledge needed to be a successful nurse

administrator (American Nurses Association, 2009, p36). The second area is how to use

their knowledge and educate employees to increase and enhance the nursing practice

(American Nurses Association, 2009, p36). The competency of collegiality will focus

on the areas of making the environment conducive to educating health care providers and

mentoring other disciplines (American Nurses Association, 2009, p.38). The next

competency is research. Research will be broken down into making sure the research

priorities align with the system strategic plan and then disseminating the research or best

practice to improve the nursing profession (American Nurses Association, 2009, p41).

The last competency is resource utilization. This will focus on developing an evaluation

method to measure interventions and outcomes along with informing the direct care

nurses about cost, risk, and benefits of planning and solutions (American Nurses

Association, 2009, p42). If these competencies are better understood, the learner will

have a good foundation for his future career as a nurse administrator.

Literature Review

Overview

This literature review will focus on understanding the smaller community hospital

setting. It will also address how a nursing administrator can uses their skills to meet the

needs of the community, patients, and nursing staff. The main areas of focus will be on

understanding the community hospital setting, nursing leadership style, quality and

safety, hospital finances, and strategic thinking.

Community Hospital

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The clinical site selected for this practicum is a smaller community hospital. It is

important to understand this setting and how it might be different from a large health care

facility. The community hospitals provide vital access for patients not located in large

cities. They play a key role in providing health services in rural areas (Li, Schneider, &

Ward, 2007). To survive in the constantly changing health care sector the Center for

Medicare and Medicaid Services (CMS) passed the Medicare Rural Hospital Flexibility

Program on the 1997 Balanced Budget Act. This program allowed certain hospitals to

apply for the designation of Critical Access Hospital (CAH). This designation allowed

the CAHs to change from a prospective payment system (PPS) to a cost-based

reimbursement program from Medicare (Lil, et al., 2007). This means they are paid a

percent of their actual cost not just diagnosis-related groups (DRGs). Hospitals enrolled

in the CAH program do better financially than other community hospitals that are still

being reimbursed under the PPS program (Holmes, Pink, Friedman, 2013). The CAH

program has been successful in ensuring the survival of small community hospitals. If

this program were eliminated, the percent of community hospitals reporting a negative

financial margin would increase from 28.2% to 44.0% (Holmes, et al., 2013). This is

why it is important to understand this program and how it works in the community

hospital setting.

The nurse administrator who is responsible for a CAH understands the need for

this program and how it can benefit the patients and the whole health system. This will

need to be understood by the learner. CAHs may be capable of caring for patients that

don’t require a higher acuity of care and can avoid transferring them to large hospitals

many miles away (Bigby, 2014). Avoiding transfers can save money and improve the

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patient and family experience in a large health system (Bigby, 2014). The learner

understands why this is important for Spectrum Health United and Kelsey Hospitals.

Knowing how to continue to advocate for this program will be important. Gaining

knowledge on how to do this will help the learner enhance their clinical practicum and

their future career as a nurse administrator.

Leadership and Theory

The theory of Jean Watson’s Relationship-Based Care (RBC) is a strong nursing

theory that impacts the direct care nurse and their nursing practice. It starts by

transforming the nurse from the inside out using 12 elements of care (Koloroutis, 2004).

These 12 elements focus on the core of nursing related to a caring and healing

environment, leadership, and teamwork. This is one nursing theory that could be applied

to nursing practice to enhance the culture of nursing in a community hospital.

Once a theory is identified the learner would implement the nursing theory.

Leading that change could be very challenging. Having strong leadership skills are

necessary. Many research articles focus on transformational leadership as a strong

leadership style. Transformational leadership skills include: modeling the way, challenge

the process, encourage the heart, inspire a shared vision, and enable others to act

(Clavelle, Drenkard, Tullai-McGuinness, & Fitzpatrick, 2012). The American Nurse

Credentialing Center (ANCC) also recognizes transformational leadership as a core

competency for Magnet designation (American Nurse Credentialing Center, 2008). Other

leadership styles are reported in the literature and support success in leading nursing

teams. Authentic leadership is one leadership style the learner possesses. Authentic

leadership and transformational leadership are very similar except an authentic leader is

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anchored by their own deep sense of self and know where they stand on important issues,

values, and beliefs (Shirey, 2006). Once the leader knows that about one’s self then they

can lead a successful team. Authentic leaders bring their real self into leadership so they

appear to the employees more genuine (Waite, Mckinney, Smith-Glasgow, & Meloy,

2014). An authentic leader is one who is perceived as open, optimistic, and resilient

(Waite, et al. 2014). Strong nursing leadership leads to a strong nursing environment

(Shirey, 2006). A strong nursing environment is linked to better quality of care and

better patient satisfaction (Tomey, 2009).

Quality and Safety

Understanding how the nursing administrators breaks down barriers to quality

care and safety will be key to the learning plan. The National Database of Nurse Quality

Indicators (NDNQI) is one database the learner can use to benchmark quality and safety

date. NDNQI started off with just 23 hospitals in 1999 and now has grown to include

over 1,800 hospitals, housing 17,000 nursing units (Gajewski, Lee, & Dunton, 2012).

This database is used to benchmark quality care related to falls, pressure ulcers, and other

nurse sensitive indicators (NSIs) (Gajewski, et al., 2012). Knowing if and how nurse

administrator’s uses this database to make decisions and improve care will be a valuable

skill the learner will develop.

Hospitals with a CAH designation are associated with enhanced performance in

certain NSIs (Li, et al., 2007). The role of the learner in achieving enhanced performance

is breaking down barriers for the employees and advocating for the work the nurses do.

In a study by Bakker et al. (2013) they found that having strong leadership endorsement,

in a community hospital, provided them the tools they needed to successfully implement

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a centralized NSI management program. This allowed them to identify and monitor each

nursing units performance related to NSIs. They were then able to implement process

improvement initiatives to improve on the quality of care that they provided (Bakker,

Keithley, 2013).

Hospital Finances

The learner will work closely with the Chief Financial Officer (CFO) on hospital

finances. Understanding how hospitals are reimbursed from Medicare/Medicaid, private

payers, and commercial payers will be essential to the learner’s growth. Also

understanding how reimbursement affects the cost of care and quality of care will be

important. Hospitals located in a very competitive market showed better outcomes in

terms of lower mortality rate but no difference in average cost (Jiang, Friedman, & Jiang,

2013). The learner will also works on cost savings projects. In a study by Covington et

al. (2013) they found that a simple education plan for physicians about how and when to

order radiology tests could reduce costs. How to create and implement projects like this

will be a key skill to learn. How does a community hospital balance quality and cost

when they are a CAH? These are discussions that involve nurse administrators and the

learner will be able to watch and learn how all of these competing priorities are managed.

Strategic Thinking

Understanding how to pull everything together for the organization is another

critical skill the learner needs to have and will develop during this clinical rotation.

Understanding individually what a CAH is, how quality and safety work, and financials

will not make a successful nurse administrator or organization. Pulling it all together and

thinking strategically is essential. A strategic plan is mandatory to help an organization

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achieve its vision and mission and must be inspiring and motivating (Brilli, Crandall,

Berry, Stoverock, Rosen, Budin,… Davis, 2014). To start the strategic planning process

it is important to use a shared governance process. Shared governance can include

leaders and direct care nurses to conduct a gap analysis related to where the nursing

division is advancing and how it fits into the whole system strategic plan. A gap analysis

helps to identify the strengths and weaknesses while providing a road map to the

preferred vision (Drenkard, 2012).

Implementing a strategic plan in the health care sector is a little more abstract

when it revolves round taking care of people (Carney, 2009). It should not only include a

gap analysis but an implementation strategy too. The strategy should include actions to

achieve objectives, and meaningful goals (Carney, 2009). They should be evaluated

during the whole implementation of the strategic plan and at multiple levels of the

organization (Carney, 2009). Terms like nursing strategic plan or strategic management

are not often found in nursing journals. With these terms not being used it might

undervalue the role of nurse managers or even CNOs when it comes to the whole system

(Carney, 2009). Starting to incorporate these terms will help the learner grow in this

competency.

After a strategic plan is developed and implemented the nurse administrator needs

to lead the team through the change. Using a shared vision and having direct care nurses

engaged helps move the plan forward when it relates to quality and safety (Newhouse,

Morlock, Pronovost, 2009). If the nurse administrator also fosters a strong work

environment and promotes professional nursing practice the quality and safety of the

patients will improve (Newhouse, et al., 2009). The way the nurse administrator can do

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this is with strong leadership skills and strong skills in the competencies discussed in the

learning plan.

Conclusion

There are many core competencies associated with a successful nurse leader.

They are also all connected. There can not be one without the other and still have a

successful team. Understanding the nursing environment is the first step in developing a

team. When the team is developed the nursing leader can use and develop their

leadership style to help move the organization and the nursing profession forward. They

can accomplish this by addressing quality and safety concerns, understanding finances,

and putting it all together by thinking strategically. A successful nurse administrator is

proficient in all of these skills.

Clinical Setting

The clinical setting for this proposed practicum is Spectrum Health United and

Kelsey Hospitals. United Hospital is located in Greenville, Michigan and Kelsey

Hospital is located in Lake View, Michigan. United Hospital includes 49 inpatient beds

and provides services ranging from labor and delivery to ICU care. They also have a full

service emergency department, surgical center, cancer center, and outpatient clinics.

Kelsey hospital is much smaller and a CAH site. They have 6 inpatient beds with a small

low acuity emergency department. Kelsey Hospital does provide some outpatient

procedures like endoscopy on certain days. United and Kelsey Hospitals are both

accredited by the Joint Commission.

The leadership structure at United and Kelsey Hospitals revolve around the

president Brian Brasser, who has a nursing background. The CNO, COO, and CFO all

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report to the president. There are many directors that report to the CNO and they range

from inpatient unit directors to respiratory and outpatient clinic directors. There are a

number of managers and supervisors that report to the directors. The direct care staff

then report to anyone from supervisors to directors depending on the area. This gives the

CNO full control over any clinical and nursing operations.

United and Kelsey Hospitals are also part of the larger Spectrum Health system.

Spectrum Health includes 11 different hospitals, many outpatient surgery and clinic sites,

a Medical Group, and Priority Health an insurance carrier. Spectrum Health employees

22,000 employees and is the largest employer in West Michigan. Spectrum Health has

many resources and is leading the way in health solutions. Their vision is to be the best

health care system by the year 2020.

Preceptor

The preceptor used for this clinical is Andre Leslie, MSN, RN, NE-BC. She

received her education at Grand Valley State University. She is currently CNO for

Spectrum Health United and Kelsey Hospitals. She has held many positions at Spectrum

Health including, staff nurse, three different nurse manager positions, director of the

Magnet program, and now the CNO. With her experience she is well versed in nursing

leadership and has demonstrated her skills in many arenas. Most recently she lead

Spectrum Health Grand Rapids to their second Magnet redesignation. The skills needed

to be a successful nurse administrator were evident during the Magnet journey at

Spectrum Health. This is one reason the learner approached her as a possible preceptor.

Andrea has many qualities identified in the Authentic Leadership theory. She has a

strong sense of self and is approachable and driven. This is why the authentic leadership

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style fits her. Working with her will give the learner a great opportunity to see nursing

leadership at its finest. After meeting with Andrea, she agreed to be the preceptor for the

learner in this practicum (see Appendix C Agreement Letter).

Evaluation Tool

The evaluation tool is an important part of the clinical practicum. The tool

developed has an evaluation during the middle of the clinical practicum and the same

format for the end. Having an evaluation during the middle of the clinical is an important

step to make sure the learner is on track. The evaluation will be presented to the clinical

preceptor at the beginning of the rotation so they have an understanding on what the

learner is looking to enhance. The final evaluation will be filled out after all the core

competencies are met during the clinical time. The tool that will be used is present in this

proposal (see Appendix B Evaluation Tool).

The evaluation tool is based on a 1 to 5 point scale. Each of the points has a

definition the preceptor and the student can use to direct them in their evaluation with 5

being the best score and 1 representing the lowest score. Each section of the core

competencies identified is broken down into the tasks associated with them. An average

score will be calculated at the end to see if the student has met expectations or not. An

average score of 3.5 or greater will indicate a passing score. This rating score was

validated by a study by Krautscheid, Moceri, Stragnell, Manthey, & Neal, (2014). Their

tool based on a 1 to 5 point scale was validated in their study and they used the score of

3.5 to indicate a satisfactory result. Having an evaluation completed in the middle of the

clinical will help identify areas where the score is below 3.5. This will allow the learner

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to focus their attention on these areas so they can meet all the requirements of their

learning plan.

Summary

This proposal outlines a comprehensive plan for the learner to follow in his

nursing clinical practicum II. The proposal starts out with a detailed learning plan that

will help guide the learner on what gaps there are in his current skill set. The literature

review gives evidence-based support for the learning plan and any other skills or

knowledge the learner will need for their clinical rotation. A well selected clinical site in

a community hospital setting will allow the learner to step out of his comfort zone of a

large hospital and learn the differences. The proven and extensive track record of Andrea

Leslie, MSN, RN, NE-BC as the preceptor will give the learner the best chance to see an

expert in her field make change and support nursing. The evaluation tool will bring

everything together and validate the education plan. With this complete proposal the

learner will be set up for success during their clinical practicum II.

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References

American Nurses Association. (2009). Scope and standards of practice: Nursing

administration. Silver Spring, MD: Nursebooks.org.

American Nurse Credentialing Center (2008). Announcing a new model for ANCCs

magnet recognition program. Retrieved from

http://www.nursecredentialing.org/Magnet/MagnetNews/2008-MagnetNews/

NewMagnetModel.html

American Nurses Credentialing Center. (2013). Transformational leadership: Criteria for

nursing excellence. Silver Spring, MD: Nursebook.org.

Bakker, D., & Keithley, J. K. (2013). Implementing a centralized nurse-sensitive

indicator management initiative in a community hospital. Journal of Nursing

Care Quality, 28(3), 241-249. dio: 101097.NCQ.0b013e31827c6c80.

Bigby, J. (2014). Examine critical access hospital payment policies within the context of

integrated systems. JAMA Internal Medicine, 174(1), 144-145. doi:

10.1001/jamainternmed.2013.11469.

Brilli, R. J., Crandall, W. V., Berry, J. C., Stoverock, L., Rosen, K., Budin, L., Kelleher,

K. J., Gleeson, S. P., & Davis, J. T. (2014). A patient/family centered strategic

plan can drive significant improvement. Advances in Pediatric, 61(1), 197-214.

dio: 10.1016/j.yapd.2014.03.009.

Carney, M. (2009) Enhancing the nurses’ role in healthcare delivery through strategic

management: Recognizing its importance or not? Journal of Nursing

Management 17(6), 707-717. dio:10.111/j.1365-2834.2009.01018.x.

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Clevelle, J. T., Drenkard, K., Tullai-McGuinness, S., & Fitzpatrick, J. J. (2012).

Transformational leadership practices of chief nursing officers in magnet

organizations. The Journal of Nursing Administration,42(4), 195-201.

Covington, M. F., Agan, D. L., Liu, Y., Johnson, J. O., & Shaw, D. J. (2013). Teaching

cost-conscious medicine: Impact of a simple education intervention on

appropriate abdominal imaging at a community-based teaching hospital. Journal

of Graduate Medical Education 5(2), 284-288. dio: 10.4300.JGME-D-12-

00117.1.

Drenkard, K. (2012). Strategy as a solution: Developing a nursing strategic plan. Journal

of Nursing Administration, 42(5), 242-243.

Gajewski, B. J., Lee, R., & Dunton, N. (2012). Data envelopment analysis in the presence

of measurement error: Case study from the national database of nursing quality

indicators. Journal of Applied Statistics, 39(12), 2639-2653. dio:

10.1080/02664763.2012.724664.

Holmes, G. M., Pink, G. H., & Friedman, S. A. (2013). The financial performance of

rural hospitals and implications for elimination of the critical access hospital

program. Journal of Rural Health, 29(2)140-149. doi: 10.1111/j.1748-

0361.2012.00425.

Jiang, H. J., Friedman, B., & Jiang, B. (2013). Hospital cost and quality performance in

relation to market forces: An examination of U.S. community hospitals in the

post-managed care era. International Journal of Health Care Finance and

Economics, 13(1), 53-71.

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Koloroutis, M. (2004). Relationship-Based Care: A Model for Transforming Practice.

Minneapolis, MN: Creative Health Care Management Inc.

Krautscheid, L., Moceri, J., Stragnell, S., Manthey, L., & Neal, T. (2014). A descriptive

study of a clinical evaluation tool and process: Student and faculty perspectives.

Journal of Nursing Education, 53(2S), S30-S33.

Li, P., Schneider, J. E., & Ward, M. M. (2007). Effect of critical access hospital

conversion on patient safety. Health Service Research, 42(6), 2089-2108. dio:

10.1111/j.1475-6773.2007.00731.x.

National Database of Nursing Quality Indicators. (2014, September 5th) About NDNQI.

Retrieved from: Http://www.nursingquality.org/#intro

Newhouse, R. P., Morlock, L., & Pronovost, P. (2009). Rural hospital nursing: better

environment = shared vision and quality/safety engagement. Journal of Nursing

Administration, 39(4), 189-195.

Shirey, M R. (2006). Authentic leaders creating healthy work environment for nursing

practice. American Journal of Critical Care, 15(3), 256-267.

Tomey, A. M. (2009). Nursing leadership and management effects work environments.

Journal of Nursing Management, 17(1), 15-25. dio: 10.1111/j.1365-

2834.2008.00963.x.

Waite, R., Mckinney, N., Smith-Glasgow, M. E., & Meloy, F. A. (2014). The

embodiment of authentic leadership. Journal of Professional Nursing, 30(4), 282-

291. dio: 10.1016.j.profnurs.2013.11.004.

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Appendix A.Learning PlanANA Standards of Practice: Nursing Administration

Outcome Criteria: Activities to Achieve Outcome

Resources needed to be successful

Nursing Administration ANA Standard 8: Education (American Nurses Association, 2009, p. 36).

Acquire knowledge and skills appropriate to the specialty area, practice setting, role, or situation (American Nurses Association, 2009, p. 36).

Learn current laws and regulations that govern the long-term care setting.

Write a report on what a CAH is and provide this to the new Director at Kelsey Hospital.

Michigan State Operations manual for surveying long term care facilities. (Center for Medicare and Medicaid Services, 2007).

Use current research finding and other evidence to enhance role performance and increase knowledge of professional issues (American Nurses Association, 2009, p. 36).

Conduct a literature search of current best practice related to professional growth.

Compile the literature to validate best practice in caring for patients.

Educate the direct care nurses on the use of Relationship Based Care in their practice.

Use this info to develop a nursing portfolio and updated resume

Use the FLITE resources at Ferris State University to conduct a literature search (Ferris State University Library, 2014).

Relationship Based Care book (Koloroutis, 2004).

Weebly Websites and update Michaelrn.com

ANA Standard 10: Collegiality (American Nurses Association, 2009, p. 38)

Establish an environment that is conducive to the education of health care providers (American Nurses Association, 2009, p.38).

Research how the adult learner functions and use this knowledge to educate health care professionals.

Look at new concepts in adult learning (Pascoe, 2014).

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Conduct classes with the education team when onboarding new nurses and physicians.

Work with Tammie Beach who does the education.

Mentors other registered nurses, nurse administrators, and colleagues as appropriate (American Nurses Association, 2009, p.38).

Research transformational leadership and Authentic Leadership

Role model transformational leadership skills and Authentic leadership skills

In a nursing leadership meeting educate the directors about transformational leadership and Authentic Leadership

Transformational Leadership: Criteria for Nursing Excellence (American Nurses Credentialing Center, 2013).

The embodiment of authentic leadership. (Waite, Mckinney, Smith-Glasgow, & Meloy, 2014)

ANA Standard 13: Research (American Nurses Association, 2009, p. 41)

Assure research priorities align with the organization’s strategic plans and objectives and include an appropriate nursing focus (American Nurses Association, 2009, p. 41).

Review the organizations strategic plan.

Prioritize the strategic plan and show how nursing plays a key role to see if is aligns with the CNO’s plan

Finish work on one area of the strategic plan.

Obtain a copy of the strategic plan from my preceptor.

Depending on the area of the strategic plan that needs attention at that time I will use different resources.

Formally disseminate research findings through activities such

Disseminate the work being done on the strategic plan to

A venue to present the findings of the project.

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as presentations, publications, and consultations (American Nurses Association, 2009, p. 41).

nursing departments.

Do this in presentation format at both staff meetings and shared leadership meeting.

Medical professionals who will listen and adopt the proposed project.Power Point

ANA Standard 14: Resource Utilization (American Nurses Association, 2009, p. 42)

Develops evaluation methods to measure safety and effectiveness for interventions and outcomes (American Nurses Association, 2009, p. 42).

Look up different quality and safety databases and complete a comparison chart.

Complete a cost comparison between different quality and safety tools.

Develop a cost to benefit ratio for one tool and present this to the CFO for approval.

Utilize the NDNQI website (National Database of Nursing Quality Indicators, 2014)

I will need time with the CFO.

Promote activities that assist others, as appropriate, in becoming informed about cost, risk, and benefit of plans and solutions (American Nurses Association, 2009, p. 42).

Meet with the health systems financial team to discuss cost.

Create education related to cost and the changing reimbursements related to the Health Care Reform Act.

Present this information to the direct care nursing staff during staff meetings.

Connect with the system’s affordable care act specialist to learn about how health care reform has and will change reimbursement for this health system.

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Appendix B. Evaluation Tool

Evaluation of Nursing Administration Competencies: Please evaluate the nursing scholar on the following competencies. Please use the following scale and definitions. (Final Evaluation)

5 Exceeds Expectations: Goes above and beyond consistently and shows great understanding of the competency

4 Above Expectations: Achieved expectations and went above and beyond on occasion while showing understanding of the competency

3 Meets expectations: Demonstrated understanding of the competency

2 Below Expectations: Did not show or demonstrate understanding of the competency

1 Did not complete: Did not work on this competency at allCompetency 5 4 3 2 1 Comments

1. ANA standard 8: EducationDemonstrated knowledge of the nurse administration role.Used current research or resources to learn about the nurse administration role.Demonstrated knowledge of the specialty facility.Understands current legislature that governs the community hospitals.Explained the importance of life long learning.Provided an updated resume and nursing portfolio related to nursing administration.

2. ANA standard 10: Collegiality

Worked professionally with clinical preceptor.Worked well with other disciplines in the clinical setting.Demonstrates good communication skills.Has the ability to mentor other registered nurses.Has the ability to mentor other nurse administrators.Shows leadership qualities that make a safe work environment for employees.Role models what an authentic leader is.

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Competency 5 4 3 2 1 Comments3. ANA standard 13: Research

Knows how to do a literature search for best practice.Demonstrated how to disseminate best practice or a change in the form of a presentation.Can apply best practice to the organization's strategic plan.Understands the importance of a strategic plan.Understands how nursing plays key a role in the organizational strategic plan.4. ANA standard 14: Resource

UtilizationCan demonstrate how to read and understand benchmark data.Understands nurse sensitive indicators (NSIs) and how they are reported.Understands community hospital financials.Understands the decision process around resource allocation.Educated the nursing staff about hospital financials and how they affect the direct care nurse.

5. Overall performanceCompleted all clinical hours.Maintained professionalism.Was an asset to our team?Showed strong leadership skills.

Yes NoI would recommend this scholar for a leadership role.

This scholar finished all the required competencies.

Preceptor Signature: Date:

Evaluation of Nursing Administration Competencies: Please evaluate the nursing scholar on

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the following competencies. Please use the following definitions. (Mid-Semester Evaluation)5 Exceeds Expectations: Goes above and beyond consistently and shows

great understanding of the competency

4 Above Expectations: Achieved expectations and went above and beyond on occasion while showing understanding of the competency

3 Meets expectations: Demonstrated understanding of the competency

2 Below Expectations: Did not show or demonstrate understanding of the competency

1 Did not complete: Did not work on this competency at allCompetency 5 4 3 2 1 Comments

1. ANA standard 8: EducationDemonstrated knowledge of the nurse administration role.Used current research or resources to learn about the nurse administration role.Demonstrated knowledge of the specialty facility.Understands current legislature that governs the community hospitals.Explained the importance of life long learning.Provided an updated resume and nursing portfolio related to nursing administration.

2. ANA standard 10: Collegiality

Worked professionally with clinical preceptor.Worked well with other disciplines in the clinical setting.Demonstrates good communication skills.Has the ability to mentor other registered nurses.Has the ability to mentor other nurse administrators.Shows leadership qualities that make a safe work environment for employees.Role models what an authentic leader is.

Competency 5 4 3 2 1 Comments

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3. ANA standard 13: ResearchKnows how to do a literature search for best practice.Demonstrated how to disseminate best practice or a change in the form of a presentation.Can apply best practice to the organization's strategic plan.Understands the importance of a strategic plan.Understands how nursing plays key a role in the organizational strategic plan.4. ANA standard 14: Resource

UtilizationCan demonstrate how to read and understand benchmark data.Understands nurse sensitive indicators (NSIs) and how they are reported.Understands community hospital financials.Understands the decision process around resource allocation.Educated the nursing staff about hospital financials and how they affect the direct care nurse.

5. Overall performanceShows up for clinical hours.Maintains professionalism.Has been an asset to our team.Shows strong leadership skills.

Yes NoThis scholar is on-track to complete the clinicals?

Preceptor Signature: Date:

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Appendix C. Agreement Letter

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Resources

American Nurses Association. (2009). Scope and standards of practice: Nursing

administration. Silver Spring, MD: Nursebooks.org.

American Nurses Credentialing Center. (2013). Transformational Leadership: Criteria

forNnursing Excellence. Silver Spring, MD: Nursebook.org.

Center for Medicare and Medicaid Services. (2007). State operations manual: Long term

care facilities. Retrieved from:

http://www.cms.gov/Regulations-and-Guidance/Legislation/CFCsAndCoPs/

Downloads/som107ap_pp_guidelines_ltcf.pdf

Ferris State University Library. (2014, September 5th). Flite. Retrieved from

http://www.ferris.edu/library/

Koloroutis, M. (2004). Relationship-Based Care: A Model for Transforming Practice.

Minneapolis, MN: Creative Health Care Management Inc.

National Database of Nursing Quality Indicators. (2014, September 5th) About NDNQI.

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· web view... leadership, and teamwork. this is one nursing theory that could be applied to...

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