Veronica Wilbur has 28 years experience as a registered nurse. Her previous practice background includes 15 years in medical intensive care, coronary intensive care and emergency room nursing. As a family nurse practitioner for 13 years, she has experience in family primary care and walk-in medical care. Her areas of expertise in teaching include pathophysiology, adult assessment and teaching theory. She also has a special interest in the area of cultural competency and nurse practitioner students.

Sarah J. CarmodyExecutive Director

Wow! The fi rst half of 2009 is already gone and the DNA has already accomplished so much. Many of the goals outlined in the last issue of the Reporter have/are coming to fruition.

In March, the DNA submitted our proposal for title

protection to the Board of Nursing for consideration. The intent of protecting the title “nurse” is to protect the public from individuals who are not nurses, yet deceitfully lead the public to believe they are nurses and have the education and skills of a registered nurse or licensed practical nurse. The regulation of nurses by the Board of Nursing offers some assurance to the public that a nurse is competent to provide services in an effective and safe way. Restricting use of the title “nurse” to those who have satisfi ed the licensure requirements ensure the protection the public deserves and affi rms the value of nursing. We are hopeful that Delaware will soon join the 24 other states that currently have this protection.

The APN Council of Delaware has re-opened its bid to allow APNs to prescribe accessible parking placards and/or plates for qualifi ed individuals with disabilities. This is an exciting and necessary step in the continuing care of the patient care population.

The DNA has added a new benefi t for members.

Tish Gallagher earned her BSN and MSN from the University of Delaware and her PhD in Nursing from Widener University. She is a Certifi ed Nurse Educator (CNE). Tish has worked for the State of Delaware as both a Public Health Nurse and a Developmental Nurse Specialist. She has also been an Assistant Professor at the University of Delaware. Since 1990, she has been employed by Wilmington University and has been Dean of the College of Health Professions there since 2001. Tish can be reached at tish.b.gallagher@wilmu.edu or at 302-356-6916.

Nursing education is critically important as health care moves into the next decade and beyond. In spite of local trends to freeze positions and possibly lay off nurses, there is still a projected shortage of 500,000 nurses by 2025 (1). The nurse educators in academic and clinical settings prepare nurses of the future. Therefore, the importance of nursing education cannot be over emphasized.

This edition of the DNA Reporter highlights nurse educator authors from across the State of Delaware–both academic and clinical educators have contributed and describe some of the innovations in nursing

current resident or

Presort StandardUS Postage

PAIDPermit #14

Princeton, MN55371

Constituent member of ANA

The mission of the Delaware Nurses Association is to advocate for the interest of professional nurses in the state of Delaware. The Delaware Nurses Association is dedicated to serving its membership by defi ning, developing, promoting and advancing the profession of nursing as an art and science.

Volume 34 • Issue 2 May, June, July 2009

Key Legislative Issues to Watch

Page 7

Inside DNA REPORTER

Constituent member of ANA

Reporter The Offi cial Publication of the Delaware Nurses Association

Executive Director’s Column . . . . . . . . . . . . 1President’s Message . . . . . . . . . . . . . . . . . . 3News from the Board of Nursing . . . . . . . . . 4Upcoming Events . . . . . . . . . . . . . . . . . . . . 5Excellence in Nurse Practice Awards Application . . . . . . . . . . . . . . . . . . . . . . . 6Delaware Cultural Competency Key Legislative Issues to Watch . . . . . . . . . . 7Facing the Challenge of Retention . . . . . . . . 8Implementing Standardized Colors for Patient Alert Wristbands . . . . . . . . . . . . . . . . . . 11

Call for Nominations for Elective Offi ce . . . 11Nurse Educator: Clearly an Advanced Practice Role . . . . . . . . . . . . . . . . . . . . . 12If Nursing is a Sea of Possibilites, Why Am I Still Adrift? . . . . . . . . . . . . . . 12Delaware Cultural Competency Education Series . . . . . . . . . . . . . . . . . . 13Data Bits . . . . . . . . . . . . . . . . . . . . . . .15-16Welcome New and Reinstated Members! . . 17DNA Membership Application . . . . . . . . . . 18

Sarah Carmody

Tish Gallagher Veronica Wilbur

Executive Director’s Column

Guest Co-Editors

Executive Directors Column continued on page 2

education around the state. We have selected articles that highlight educational innovation in academia and practice. The articles range from discussion of accreditation, advance practice nurse educators, to implementing patient safety standards in the hospital setting. The common theme in all of these articles is the role of the nurse educator.

1. Despite Surge of Interest in Nursing Careers, New AACN Data Confi rm that Too Few Nurses are Entering the Healthcare Workforce. 26 February 2009. http://www.aacn.nche.edu/Media/NewsReleases/2009/workforcedata.html

Nursing Education

Delaware Cultural Competency Education

Series

Page 13

Page 2 • DNA Reporter May, June, July 2009

OFFICIAL PUBLICATION of the

Delaware Nurses Association5586 Kirkwood HighwayWilmington, DE 19808

Phone: 302-998-3141 or 302-998-3142 FAX 302-998-3143Web: http://www.denurses.org

The DNA Reporter, (ISSN-0418-5412) is published 4 times annually, by the Arthur L. Davis Publishing Agency, Inc., for the Delaware Nurses Association, a constituent member association of the American Nurses Association.

EXECUTIVE COMMITTEEPresident TreasurerNorine Watson, RN, Gloria Zehnacker, CRNA, APNMSN, NEA-BC

Past President SecretaryPenelope Seiple, RN, VacantMSN, NE-BC, FACHE

COMMITTEE CHAIRSContinuing Education Advanced PracticeNancy Rubino, EdD, RNC Leslie Verucci, MSN, RN,(Acting) CNS, ARPN-BC, CRNP

Nominating Professional Development Moonyeen “Kloppy” Karen Carmody, MSN,Klopfenstein, MS, RN, CRNPIBCLC, CPUR

Legislative CommunicationsAnn Darwicki, RN Heidi LeGates, MSN, RN, NEA-BC Bonnie Osgood, RN-BC, MSN, Environmental Ad-Hoc NE-BCMichelle Lauer, RN, MSN, BCNursing Healing Our Planet (NHOP)

DNA DELEGATES to the ANA House of DelegatesNew Castle County: Nati Guyton, RN, MSN

Kent County: Karen Panunto, RN, MSNSussex County: Kelly Davis, RN, MSN

DNA President: Penelope Seiple, RN, MSN, NE-BC, FACHEAlternates-at-Large:

Marianne Ford, RN, MSBetty Stone, RN, MS, OCN

Diane Talarek, RN, MA, CNA

Executive DirectorSarah J. Carmody, MBA

Offi ce AssistantRosemary Finlayson, BS

Subscription to the DNA Reporter may be purchased for $20 per year, $30 per year for foreign addresses.

Acceptance of advertising does not imply endorsement or approval by the Delaware Nurses Association of products advertised, the advertisers, or the claims made. Rejection of an advertisement does not imply a product offered for advertising is without merit, or that the manufacturer lacks integrity, or its use. DNA and the Arthur L. Davis Publishing Agency, Inc. shall not be held liable for any consequences resulting from purchase or use of an advertiser’s product. Articles appearing in this publication express the opinions of the authors; they do not necessarily re� ect views of the staff, board, or membership of DNA or those of the national or local associations.

Advertising Rates Contact—Arthur L. Davis Publishing Agency, Inc., 517 Washington St., P.O. Box 216, Cedar Falls, Iowa 50613, 800-626-4081, sales@aldpub.com. DNA and the Arthur L. Davis Publishing Agency, Inc., reserve the right to reject any advertisement. Responsibility for errors in advertising is limited to corrections in the next issue or refund of price of advertisement. Material is copyrighted 1997 by the Delaware Nurses Association and may not be reprinted without written permission from DNA.

Managing EditorsHeidi LeGates, MSN, RN, NEA-BC

Bonnie Osgood, RN-BC, MSN, NE-BC

PhotographerWilliam Campbell, EdD, RN

The DNA Reporter welcomes unsolicited manuscripts by DNA members. Articles are submitted for the exclusive use of The DNA Reporter. All submitted articles must be original, not having been published before, and not under consideration for publication elsewhere. Submissions will be acknowledged by e-mail or a self-addressed stamped envelope provided by the author. All articles require a cover letter requesting consideration for publication. Articles can be submitted electronically by e-mail to Heidi LeGates, MSN, RN, NEA-BC @ Heidi_Legates@Bayhealth.org or Bonnie S. Osgood, RN-BC, MSN, NE-BC, @ bosgood@christianacare.org.

Each article should be prefaced with the title, author(s) names, educational degrees, certi� cation or other licenses, current position, and how the position or personal experiences relate to the topic of the article. Include af� liations. Manuscripts should not exceed � ve (5) typewritten pages and include APA format. Also include the author’s mailing address, telephone number where messages may be left, and fax number. Authors are responsible for obtaining permission to use any copyrighted material; in the case of an institution, permission must be obtained from the administrator in writing before publication. All articles will be peer-reviewed and edited as necessary for content, style, clarity, grammar and spelling. While student submissions are greatly sought and appreciated, no articles will be accepted for the sole purpose of ful� lling any course requirements. It is the policy of DNA Reporter not to provide monetary compensation for articles.

ReporterVision: The Delaware Nurses Association is dedicated to serving its membership by de� ning, developing, promoting and advancing the profession of nursing as an art and science.

Mission: The Delaware Nurses Association advocates for the interest of professional nurses in the state of Delaware.

Goals: The Delaware Nurses Association will work to:1. Promote high standards of nursing practice, nursing

education, and nursing research.2. Strengthen the voice of nursing through membership

and af� liate organizations.3. Promote educational opportunities for nurses.4. Establish collaborative relationships with consumers,

health professionals and other advocacy organizations.5. Safeguard the interests of health care consumers and

nurses in the legislative, regulatory, and political arena.6. Increase consumer understanding of the nursing

profession.7. Serves as an ambassador for the nursing profession.8. Represent the voice of Delaware nurses in the national

arena.

Upcoming Reporter Themes

• August/September/October— Technology and Nursing• November/December/January 2010— Palliative Nursing• February/March/April 2010 Health Care Economics

Happy Nurses Week!

National Nurses Week is celebrated annually from May 6, also known as National Nurses Day, through May 12, the birthday of Florence Nightingale, the founder of modern nursing.

Happy Nurses Week to all those who make a difference in their patients lives and are committed to making a positive change in the delivery of care!

The DNA has partnered with InsureEZ to offer our members the best rates in the marketplace for health and dental insurances, term life insurance, auto and homeowners insurance as well as other programs. Please visit www.insureEZ.net/dna or call 1-888-744-2121. The DNA will continue to add to our list of benefi ts. If there is a product or service you would like the DNA to investigate for a benefi t, please give me a call or send an email to sarah@denurses.org.

Congratulations to the Professional Development and Continuing Education committees! Thanks to the efforts of both committee members, the DNA was re-accredited as an ANCC provider and approver of nursing continuing education for the next four years. Great work!

The DNA has moved forward with partnering other organizations to provide quality continuing education for the nursing community. The Professional Development committee has collaborated with the Delaware Health and Social Services, the Delaware Academy of Family Physicians, the Delaware Academy of Medicine and the National Medical Association to bring you the Cultural Competency Series which runs from March to May. They have also done a great job pulling together the spring APN and DNA conferences into one event with ANA President Becky Patton as the keynote speaker.

The DNA will be working with DTCC-Georgetown campus to develop the Fall DNA conference. Thank you to Kelly Davis, DTCC instructor and DNA delegate for proposing the collaboration and to those DNA members working to make this a fantastic event. Mark your calendars for October 22, 2009!

This is an election year for president-elect, three ANA/DNA delegates, secretary and for members of the nominating committee. Please consider running for offi ce. It is a great way to meet colleagues from around the state and to make a difference in the direction of the Association. Qualifi cations and details of each position can be found on the website under the “about” tab. Winners will be announced at the Fall 2009 conference.

The NHOP group also has scheduled two more Medicine Take Back events this year supported by local hospitals. The April 23rd event was held at Christiana Care Hospital and the June 1st event will be held at Bayhealth Medical Center. Thanks to all of the volunteers, the DEA, law enforcement and all those who give their time and resources to make these events possible. A special thanks to Christiana Care Hospital and Bayhealth Medical Center for supporting these events. Without their support these Medicine Take Back events would not be possible.

And lastly, the Delaware Nurses Association license plate. I am hoping that by the time this issue has been printed and distributed, the application will be available for DNA members to apply for the very fi rst Delaware license plate supporting nursing. The fi rst 20 numbers will be retained for a silent auction with proceeds to support the development of the Delaware Nursing Foundation and education scholarships. In order to get this fi rst ever Delaware nursing license plate, you must be a DNA member. Thank you to Chris Foard for his infectious enthusiasm for this project and for helping to make it happen.

Executive Directors Column continued from page 1

May, June, July 2009 DNA Reporter • Page 3

Norine WatsonDNA President

I read a report recently that indicated that even during the current economic turndown nursing jobs are still available. Nursing salaries are improving and there are opportunities in nursing for professional and clinical advancement.

But despite this positive news for Healthcare positions it is still a good time to give

your career a “once over”. Take these steps to make your career risk proof. Start off by reading this edition of the DNA Reporter carefully and thinking about how you might advance your professional education. I believe it was Florence Nightingale who wrote, “we as nurses are never complete”. Don’t think of your bachelor’s degree as your terminal professional degree. Consider going back to school to add a MSN, DNP or a PhD to your credentials. We are at our best when we are learning and growing; the professional experience that you have gained from your career to this point will add a new level of depth and understanding to your studies you may not have experienced with your earlier degrees. Additionally, your professional practice will change in ways that you can not even anticipate before you get started.

We celebrated National Certifi ed Nurses’ Day on March 19th. With this date and Dr. Gretta Style’s work in mind, the next career enhancement step I offer is to attain a specialty certifi cation or to help a colleague work to achieve this goal. Even though

indicated that even during the current economic turndown nursing jobs are still available. Nursing salaries are improving and there are opportunities in nursing for professional and clinical advancement.

Norine Watson

President’s Message

Wit and WisdomHow wonderful it is that nobody need wait

a single moment before starting to improve the world.

~Anne Franke

Change will not come if we wait for some other person or some other time. We are the ones we’ve been waiting for. We are the change that we seek.

~President Barack Obama

What’s New with Member Benefits

Another way Delaware Nurses Association is helping you cut your personal expenses…

Check out our money saving programs such as: health, life, disability, auto, homeowners insurance & more…

Through a partnership with www.InsureEz.net, DNA members are offered the best rates in the marketplace.

V i s i t w w w. I n su r eE z .ne t/DN A o r c a l l 1-888-744-2121

Nursing Stays on Course while the World Goes Crazy Around Us...

it takes time, money and effort everyone I talk to readily admits that they understood their nursing specialty better after preparing for a certifi cation exam. Plus it is impossible to quantify the boost in professional confi dence that goes along with receiving notifi cation of successfully passing the exam. Start to prepare today, you owe it to yourself and to those who count on you for their care.

Finally think about what you would need to do to be the nurse on your unit that your manager or supervisor could not do without. Start out by imagining that your unit is undergoing some changes and that your personnel fi le is on your management team’s desk. Would your boss fi ght to keep you on her team? You have control over how you are perceived at work and some ways to ensure it is as an outstanding contributor are to support the goals of your unit and your department, stay on top of your work email, read articles that are pertinent to your specialty, participate in research studies and join committees. Never hesitate to volunteer discretionary effort.

But the most important suggestion I can make is to manage your attitude and your conversations. Try not to bring personal and family problems to work with you and keep your conversations positive and focused on the patients that you are caring for. The words you choose, the level of your conversations and your approach to your work, be it–“can do” or “ain’t it awful”–are how your peers and your supervisors know you. Making seemingly small changes can result in a big change in your professional image. Your patients, co-workers and management team will thank you for taking these steps to be indispensible.

Page 4 • DNA Reporter May, June, July 2009

News from the Board of Nursing

Pamela C. Zickafoose, EdD, MSN, RN, CNA-BC, CNE earned her EdD, MSN, and BSN from the University of Delaware. She is board certifi ed in Nursing Administration and is a Certifi ed Nurse Educator. Dr. Zickafoose has over 20 years experience in nursing education with positions held at Bayhealth Medical Center, Delaware State University and Delaware Technical & Community College. Dr. Zickafoose is a member of the nursing faculty at Delaware Technical & Community College-Terry Campus and a relief staff nurse in ICU at Bayhealth Medical Center. She is also President of the Delaware Board of Nursing and a member of the National Council of State Boards of Nursing (NCSBN) Transition to Practice Committee. Dr. Zickafoose can be reached at pzickafo@dtcc.edu or by phone at 302-857-1347.

The nurses of Delaware were fi rst introduced to the National Council of State Boards of Nursing (NCSBN) Transition to Practice Committee at the Nurse Educator Update held at Delaware Technical & Community College–Terry Campus in June 2008. The NCSBN Board of Directors charged the Transition to Practice Committee to: Recommend an evidence-based regulatory model for transition to practice. It was believed there was a need for this model because of the tremendous changes in healthcare over the past 20 years which have altered practice and resulted in a greater concern for more safe and effective care. Nursing education, practice and regulation needed to collaborate on this very important issue. Numerous factors were related to the need for a transition model including medical errors which have been a major concern for the health professions. The Institute of Medicine reported that medical errors kill more people than breast cancer, AIDS or automobile accidents (Kohn, Corrigan & Donaldson, 1999). At the same time, there has been an increased complexity of care for sicker patients with multiple conditions, a continued need for systems thinking, and technologic advances, along with a shortage of nurses and faculty that is expected to continue into the future. Another issue that prompted this transition to practice initiative was the implementation of computer adapted testing, which allows new graduates to become licensed within days of passing the NCLEX®. Previously, new graduates waited for months for their results thus working under the supervision of licensed nurses (Spector & Li, 2007). All of this was the impetus for the NCSBN to look at transitioning new nurses into practice, through regulation.

The Transition to Practice Committee fi rst explored the evidence and developed an Evidence Grid (NCSBN, 2008a). The evidence supported the Transition to Practice Committee’s decision that post-graduate nurse transition programs protect the public. Next the committee developed a conceptual model for transition, which is a collaborative model that will be implemented through regulation. Collaboration between education, practice and regulation is essential for this model to be successful. Educators are the experts in curriculum design and evaluation and will be able to assist with the design of the transition modules. Practice provides that crucial link that will provide new graduates with planned practice experiences with qualifi ed nurses to mentor them. Regulation not only will be able to enforce the transition program, through licensure, but regulators will be able to provide new graduates with information on their scope of practice, the Nurse Practice Act, and maintaining their license throughout their careers (NCSBN, 2009).

Many organizations have implemented transition programs but not for all settings and levels of nurses. This Transition to Practice Model (Figure 1) is inclusive of all health care settings that hire newly graduated nurses and it pertains to all

Transition to Practice UpdateJanuary meeting a conference call was held with representatives from the American Association of Colleges of Nursing (AACN), American Nurses Association (ANA), American Organization of Nurse Executives (AONE), National League for Nursing (NLN), National Association for Practical Nurse Education and Service (NAPNES), University Health System Consortium (UHS), and National Association of Directors of Nursing Administration/Long Term Care (NADONA-LTC). These stakeholders provided valuable input and were supportive of the transition model. Another collaborative call with nursing organizations/stakeholders will be held at our March meeting. One major concern is fi nancial support of the model. Therefore, the committee is exploring possible funding sources. The evidence does indicate that effective transition programs reduce costs for employers due to reduced turnover and safer care resulting in more positive patient outcomes.

In March 2009, the progress from the January meeting will be reported at the NCSBN Mid-Year meeting. The Transition to Practice Committee will meet later in March to continue working on this year’s charges. It has been suggested and is anticipated that a pilot of the transition model will be conducted before the project is implemented nationally. Outcomes data will be collected and presented to NCSBN’s membership.

ReferencesCronenwett, L., Sherwood, G., Barnsteiner, J., Disch,

J., Johnson, J., Mitchell, P., Sullivan, D. T. & Warren, J. (2007). Quality and safety education for nurses, Nursing Outlook, 55(3), 122-131.

Kohn, L., Corrigan, J., Donaldson, M. Eds. (1999). To err is human: Building a safer health system. Washington DC: The National Academies Press.

NCSBN. (2009). Description of NCSBN’s Transition to Practice Model. Sent to Member Boards January 2009.

NCSBN. (2008a). Transition evidence grid. Retrieved February 16, 2009, from www.ncsbn.org/Final_08_Transition_grid.pdf

NCSBN. (2008b). Regulatory model for transition to practice report. Retrieved February 16, 2009, from www.ncsbn.org/388.htm

NCSBN. (2008c). Toward an evidence-based regulatory model for transitioning new nurses to practice, in Leader to Leader Fall 2008. Chicago, IL: NCSBN.

Spector, N. & Li, S. (2007). A regulatory model on transitioning nurses from education to practice. JONA’s Healthcare Law, Ethics, and Regulation, 9(1), 19-22.

Figure 1Transition to Practice Model

Pamela Zickafoose

educational levels of nurses. Once new graduates pass the NCLEX®, they enter the transition program. Orientation in this model is considered being instructed on the policies and procedures of the workplace, as well as role expectations. Therefore, orientation is separate from the concept of transition to practice, which is a formal program designed to support newly licensed nurses during their progression into practice. Once orientation is completed, the newly licensed nurses enter the transition portion of the model. There are eight transition modules including delegating/supervising, role socialization, utilization of research, prioritizing/organizing, clinical reasoning, safety, communication, and specialty content. These were identifi ed from the literature and are supported by the evidence. These modules could be presented at the institution where the new nurse works, in a shared methodology with other institutions, or via the Internet. The Transition to Practice Committee plans to work with the NCSBN E-Learning Department to develop web-based learning modules and to facilitate nurse-preceptor relationships.

The outcomes of the Transition to Practice Model are based on Quality and Safety Education for Nurses (QSEN) Competencies: Patient Centered Care, Teamwork and Collaboration, Evidence-Based Practice, Quality Improvement, Safety, and Informatics (Cronenwett, et al, 2007). The time period for the model will be 6 months, although it is expected that the new graduate will have ongoing support for another 6 months. At the end of the year, the new nurse should be able to successfully meet competencies necessary for safe nursing practice. In order for the newly licensed nurse to maintain licensure, s/he will need to provide the state Board of Nursing with a Transition to Practice Verifi cation (TPV) form, which will be signed by the new nurse and an administrator, attesting that the new nurse has met all the requirements of the jurisdiction’s transition program (NCSBN, 2008b).

Besides being charged with developing an evidence-based model to transition new graduates to practice, the Transition to Practice Committee members were also charged to collaborate with Member Boards and stakeholders regarding the future regulatory model, to identify strategies for the model, and to develop model rules. At the

May, June, July 2009 DNA Reporter • Page 5

Delaware Technical and Community College, Owens Campus will have their re-accreditation visit from the National League for Nursing Accrediting Commission (NLNAC) October 13-15, 2009. This will be their third visit, having earned their initial accreditation in 1996. With each accreditation/re-accreditation, the program has written to revised NLNAC Standards and Criteria; this time is no exception.

The NLNAC released the 2008 edition of their Standards and Criteria in February 2008. This edition was substantially different from the 2006 edition. Those programs being accredited/re-accredited in the fall 2009 are the fi rst to utilize the new Standards. A description of the new standards will follow a brief overview of the purpose of and processes surrounding accreditation.

To quote from the 2008 Edition of the Accreditation Manual: “The purpose of the NLNAC is to provide specialized accreditation for programs of nursing education, both postsecondary and higher degree, which offer either a certifi cate, a diploma, or a recognized professional degree (clinical doctorate, master’s, baccalaureate, associate, diploma, and practical)” (p. 1). The NLNAC currently accredits over 1200 programs. As the sole accrediting agency for associate degree, diploma, and practical nursing programs, the NLNAC conducted 120 program evaluation visits to these three program types in 2007-2008 with 119 visits scheduled for 2008-2009 (NLNAC website). All three campuses of Delaware Tech, University of Delaware, Delaware State University, Wesley College, Beebe School of Nursing, and Wilmington University currently hold full accreditation from the NLNAC. Wilmington University is also accredited by the Commission on Collegiate Nursing Education (CCNE).

Accreditation site visits are conducted by program evaluators, volunteers from education and service who conduct the three to fi ve day visits as peer reviewers to verify, clarify, and amplify the information contained in the school’s self study report. Currently, there are nine Delaware program evaluators from educational programs at the associate, baccalaureate, and master’s levels (NLNAC website). Three of these program evaluators are from the Owens Campus: Jennifer Akey, Sally Danz and Tammy Paxton.

The 2008 Standards for all educational program types address the entire program and are the following:

• Mission and Administrative Capacity• Faculty and Staff• Students• Curriculum• Resources• Outcomes.The specifi c criteria for each standard vary by

program type. There is also a specifi c criterion for each standard, regardless of program type, that addresses distance education. This article will summarize the criteria for associate degree education, the program type for initial preparation for the majority of registered nurses nationwide.

The Mission and Administrative Capacity Standard has nine criteria covering issues such as mission, philosophy, program outcomes, communities of interest involvement, partnerships, faculty and students involvement in the department/college; qualifi cations and authority of the nursing administrator; integrity of policies, and the mechanism by which complaints/grievances are handled and resolved.

The Faculty and Staff Standard also has nine criteria that examine credentialing for both full and part-time faculty/staff; adequacy in terms of numbers of faculty/staff; orientation and mentoring; evaluation of faculty/staff performance, and faculty scholarship. A new aspect of one criteria in this standard is the requirement that faculty must demonstrate evidence-based teaching and clinical practices. Owens Nursing Department was fortunate to have one of our faculty members, Karen Watts, attend the 2008 Summer Institute on Evidence-Based Practice: Innovation for Quality and Safety in San Antonio. As part of this institute, Ms. Watts was invited to participate in the national consensus-forming expert panel and invitational roundtable whose goal was to defi ne essential evidence-based practice (EBP) competencies to be incorporated into associate degree education. EBP competencies already exist for baccalaureate, masters, and doctoral education and these were used as a basis for the development of the associate degree EBP competencies. The associate degree education EBP competencies are expected to be published in 2009. These competencies will help guide the incorporation of EBP into our curriculum. Mrs. Watts has also provided educational programs for the Owens nursing faculty to learn about the basic tenets of EBP.

The Students Standard has seven criteria that encompass policies, student services, student record-keeping, the integrity and consistency of information provided to the public; how changes in policies are communicated; how students are oriented to and supported in their use of technology; and the campus’ compliance with the Higher Education Reauthorization Act Title IV which guides fi nancial aid.

The Curriculum Standard has eight criteria covering all aspects of curriculum such as the inclusion of professional standards, guidelines and

competencies; the inclusion of clearly articulated student learning and program outcomes; the curriculum’s rigor and currency; the inclusion of cultural, ethnic and socially diverse concepts; the evaluation methodologies used; the length of the program; and the appropriateness of clinical experiences to the accomplishment of student learning outcomes. This standard also requires that programs demonstrate the use of educational theory, interdisciplinary collaboration, research, and best practice standards. Clinical experiences must refl ect current best practices and nationally established patient health and safety goals.

The Resources Standard has three criteria that assess the fi scal, physical, learning, and technology resources available to faculty and students. These resources are assessed in terms of their adequacy for the completion of program goals.

The fi nal standard, Outcomes, has six criteria that require the measuring and reporting of program outcomes in the areas of NCLEX-RN passage rate, program completion rate, program satisfaction and job placement rate. Also in this standard is the requirement for programs to have a comprehensive systematic plan for evaluation of each of the NLNAC standards as well as the student learning and program outcomes. The program must demonstrate that the results of their systematic evaluation plan are used to make decisions, to maintain or improve student learning outcomes, and that the results are shared with communities of interest.

The Owens Campus faculty are busy preparing the fi nal draft of their 200-page self study report in response to the 2008 NLNAC Standards. It is an exhaustive process but one that is affording us the ability to learn from one another and to work together to improve our program.

Submitted by: Tamala Dykes Paxton, Owens Campus Department Chair/Instructional Director

ReferencesNational League for Nursing Accrediting Commission,

Inc. (2008) NLNAC Accreditation Manual (2008 Edition). New York: Author.

Watts, K. (2008). Teaching nursing faculty concerning using evidence-based practice in associate degree nursing education. (Masters Capstone project, Wilmington University, 2008).

Delaware Tech Owens to have Accreditation Visit October 2009

Upcoming EventsCultural Competency SeriesMay 7, 2009

Cultural Competence in Health and Social ServicesFREE for DNA/DAFP/NMA Members

May 19, 2009Creating a Culturally Sensitive Health Care EnvironmentFREE for DNA/DAFP/NMA Members

June 13, 2009The Role of Primary Care Provider in HIV CareSt. Francis Hospital, Wilmington

Medicine Take Back EventDate: June 1, 2009Location: Bayhealth Medical Center

Nurse Excellence Awards BanquetJuly 16, 2009Modern Maturity CenterVisit www.denurses.org to download Nurse

Excellence application.2009 Fall Conference

October 22, 2009DTCC-Owen CampusArts and Science Center Georgetown, DE

January-February 2009 Approved Providers

and ProgramsVA Medical Center—ProviderDSNA 9th Annual Winter Conference—DSNAOur Journey of Hope—Aldersgate Methodist

ChurchThe 20th Annual Update in Cardiology—

Cardiology Associates

Karen A. Carmody, MSN, FNP-BC, RN; Chair

Congratulations! The American Nurses Credentialing Center’s Commission on Accreditation has granted accreditation to the Delaware Nurses Association Provider Unit for another FOUR years. Our thanks go out to those Professional Development Committee members who worked on that application to make this award possible.

It takes a concerted effort to keep the DNA continuing education programs affordable, available and of interest to all Delaware nurses. This year is no exception. The committee has been meeting regularly to fl ush out programs for members and non-members, students and advanced practice nurses. The spring of 2009 will bring the fi rst combined DNA/APN program to the University of Delaware’s Clayton Hall on April 30, 2009. Rebecca Patton, ANA President, will return once more to Delaware to visit hospitals and educational facilities, before giving the keynote at the conference. Mark your calendars and sign up early. Seating is limited.

Other PDC activities include partnerships with the Delaware Division of Public Health and the Delaware Academy of Family Physicians to bring a series of Cultural Competency Workshops to healthcare providers across the state from March through May 2009–FREE for DNA Members. Don’t miss the Environmental Conference “Shaping Our Legacy, Women’s Health and the Environment” Thursday, April 9, 2009 1:00pm-5:00pm at Christiana Care Hospital–also FREE for DNA Members. Look for smaller low cost or FREE CE events throughout the year on topics such as the Primary Care Provider’s Role in HIV Care, Women and Health Disease, Pain Management across the Spectrum.

Many Advanced Practice Nurses have asked why DNA stopped giving contact hours for monthly dinner meetings. The ANCC Standards for Commercial Support states that “A CE provider must ensure that the following decisions were made free of the control of a commercial interest”. (a) Identifi cation of CE needs;

Professional Development Committee(b) Determination of educational objectives; (c) Selection and presentation of content; (d) Selection of all persons and organizations that will be in a position to control the content of the CE; (e) Selection of educational methods; (f) Evaluation of the activity. A commercial interest cannot take the role of non-accredited partner in a joint sponsorship relationship”. Accordingly, the Delaware Nurses Association is unable to ensure that the program funded by the pharmaceutical company is a bona fi de educational program and that the fi nancial support is not an inducement to prescribe or recommend a particular medication or course of treatment. However, the Advanced Practice Nurses still desire to have the latest, most accurate information available regarding prescription medicines, which play an ever-increasing role in patient healthcare. Therefore, they continue to meet monthly for a pharmacology lecture and networking.

If you have a special interest in nurses’ continuing education, please consider volunteering to work with the planning committee to implement these and other Professional Development programs for Delaware nurses. We have lots of fun and any registration fee is reduced for all active committee members. Contact the DNA offi ce at 302-998-3141.

Page 6 • DNA Reporter May, June, July 2009

Please remember to review your application in its entirety, as incomplete applications will not be accepted. If you are completing this application electronically, you may use this document as a template for completing the application. Please mark/type where appropriate.

A blind review process will be used for selecting award winners.Deadline for application submission is June 1, 2009.

Applications may be emailed to nurseexcellence@denurses.org or via US Mail to:Delaware Nurses Association

5586 Kirkwood HighwayWilmington, DE 19808

Note: Applications (.doc or pdf format) may be burned to a CD and mailed to the above address. Please keep a copy of your nomination for your records. You will receive a confirmation notice. This confirmation notice

ensures that we’ve received your nomination and no further action will be necessary on your part.

A. I am nominating ____________________________________________ for the category of:

*A new nurse graduate is classified as an individual who has successful passed the NCLEX exam and has been employed in the nursing field for less than twelve (12) months.

The candidate is employed by ______________________________________________________ Unit: __________________

Work Phone: ( ) _________________ Home Phone: ( )_________________ Email: _____________________________

Home Address:Street: ______________________________________ City: _____________________ State________ Zip Code:____________

Provide a brief paragraph under each statement. Your responses should be carefully written and include elements of the scoring criteria listed below.

B. State in your own words how this candidate exhibits Excellence in Nursing. Please do not refer to the nominee or their employer by name in this portion of the nomination.

C. Tell us about a specific situation where this candidate has gone above and beyond in his/her area of work. Please do not refer to the nominee or their employer by name in this portion of the nomination.

D. If submitting for the Nurse Educator category, please address one of the following. Please do not refer to the nominee or their employer by name in this portion of the nomination.• Explain how the nurse educator participated in patient assessment through the development of

screening tools, research projects or epidemiological studies.• Describe the nominee’s scholarly activities: this may include the conduct and dissemination of

research; presentations at local and regional conferences; or integration and synthesis of past research.

• Describe how the nominee has assessed learning needs of groups or individuals, developed and implemented programs and provided outcome analysis based on established Educational Design Criteria.

E. Identify other professional qualities that the candidate has shown in his/her profession (check all that apply). Leadership activities Participation in research activities Membership in professional organizations Involvement in continuing education activities, such as presenting lectures and publishing Community service or volunteer activities Other ______________________________________________________________________________________________

Please attach any additional information to support each quality selected with comments, awards, media items, and noteworthy events that you would like the selection committee to consider.

F. Your Information

Name: __________________________________________________________________________________________________

Employed by _________________________________________________________________ Unit: ____________________

Work Phone: ( ) ________________________ Email: ______________________________________________________

Thank you for your nomination.Please visit www.denurses.org for the time and location of the awards ceremony.

Delaware Excellence in Nurse Practice Awards Application

Acute Care-Hospital based Long-Term Care-SNF, Hospice Community-Based Care-Home

Care, Office, School

Advanced Practice Nurse Nurse Leader/Manager Nurse Educator New Nurse Graduate*

Nurse LeaderEnvironment for Practice 25 pointsLeadership 25 pointsHealth Policy 15 pointsScope of Influence 10 pointsGeneral Comments 5points 100 points

Acute CareClinical Practice 40 pointsManagement 25 pointsAdvocacy 10 pointsProfessional Qualities 20 pointsGeneral Comments 5 points 100 points

Community-Based CareClinical Practice 40 pointsManagement 25 pointsAdvocacy 10 pointsProfessional Qualities 20 pointsGeneral Comments 5 points 100 points

Scoring Criteria

Long-Term CareClinical Practice 40 pointsManagement 25 pointsAdvocacy 10 pointsProfessional Qualities 20 pointsGeneral Comments 5 points 100 points

Nurse EducatorEducation 35 pointsHealth/AcademicCounseling 10 pointsScholarship 35 pointsScope of Influence 10 pointsGeneral Comments 10 points 100 points

Advance PracticeEnvironment for Practice 40 pointsLeadership 20 pointsHealth Policy 20 pointsScope of Influence 15 pointsGeneral Comments 5 points 100 points

New Nurse GraduateClinical Practice 35 pointsManagement 15 pointsAdvocacy 15 pointsProfessional Qualities 30 pointsGeneral Comments 5 points 100 points

Delaware Nurses Association

ANCC WebinarsLast month, ANCC has announced the availability

of the new 2009 Accreditation manual. ANCC is planning a series of webinars regarding the changes in the manual and other aspects of the CE ‘business’.

• These webinars will begin on April 29th at 1:00pm (Eastern).

• There will be five webinars of about 90 minutes (each) in length. You may choose to attend each one or only those that are of interest to you.

• The webinars will be presented by MaryMoon Allison, MHSE, BSN, RN and Pam Dickerson, PhD, RN-BC

• The topics of the webinars are:• April 29th at 1:00pm EDST: Highlights

of 2009 Criteria (lead speaker: MaryMoon Allison)

• May 14th at 1:00pm EDST: Forms and Tools (lead speaker: Pam Dickerson)

• May 28th at 1:00pm EDST: Monitoring Processes/Activities (lead speaker: MaryMoon Allison)

• June 10th at 1:00pm EDST: Retaining CE Business (lead speaker: Pam Dickerson)

• June 25th at 1:00pm EDST: Use of Volunteers in Approver Units (lead speaker: Pam Dickerson)

• Registrants for each webinar will receive, via email, the power point slides for the session for which registered. At this time, the registrant will also receive the telephone number and passcode to use for the webinar.

• The didactic portion of the presentation will be provided telephonically. Please plan to have computer access at the time you participate in the webinar. Use of cell phones for participation in the webinar is prohibited.

• The didactic portion of the webinar will be recorded. It will be accessible for at least 60 days following the webinar. To receive the power point slides and to access the recording, you must contact the ANCC Accreditation Program for the needed information (Slides, telephone number and passcode to use)

• There is no cost for these webinars. There is no limit to the number of individuals that may ‘listen in’ to the webinar.

Please help to ensure these webinars address your questions and concerns. Share your questions/concerns with by April 14th so that appropriate information can incorporate into the presentation. Send comments to sarah@denurses.org.

If you plan to participate, please send your name, phone number and email information along with the session(s) you plan to attend to sarah@denurses.org by April 28, 2009.

Anyone that applies to the DNA for program/provider approvals or are responsible for continuing nurse education at their organization are strongly encouraged to participate.

May, June, July 2009 DNA Reporter • Page 7

Ann Darwicki R.N.

State LevelHouse of Representatives

House Bill #75This Bill allows each competent adult patient

to receive visits in a Hospital, nursing home or nursing facility from any individual from whom the patient desires to receive visits, subject to certain restrictions set forth in a visitation policy related to the patient’s medical condition, the number of visitors simultaneously permitted in a patient’s room, and visitation hours and/or order of a Court. In addition, this Bill requires the Hospital, nursing home or facility to honor advance health-care directives and any similar documents, subject to certain limitations set forth in the Bill.

House Bill #69This Bill establishes a career training program for

direct care staff providing long-term care services to enhance consumer care and satisfaction with improved employee training and retention. This Bill is modeled after a similar act in Pennsylvania.

House Bill #64This bill enables small businesses in the State,

such as school bus contracting businesses, to participate in the State Group Health Insurance Program at no cost to the State, effective July 1, 2009.

House Bill #44 w/HA 1This Act authorizes the State Fire Prevention

Commission to incorporate a non-profi t, non-stock corporation for the purpose of establishing, administering and operating an overnight camp devoted to helping young people who have suffered severe burns deal with the physical and emotional issues arising from such injuries. (passed)

House Bill #42This Act creates the Delaware Psychiatric Center

Authority and removes the Center from the purview of the Department of Health and Social Services.

House Bill #41 As the State mental health delivery system evolves

from a primarily institutional to a community-based model, it is important to defi ne minimum patient rights in community facilities. This Act establishes a community mental health treatment act with rights paralleling those of patients in the substance abuse treatment system compiled in Chapter 22 of Title 16 of the Delaware Code.

House Bill #39Currently statutory anti-retaliation and protective

provisions for patients and others only apply to licensed long-term care (LTC) facilities. Only part of the Delaware Psychiatric Center (DPC) is a licensed LTC facility. This Bill, to protect all patients and employees at DPC, applies such protections to all the DPC facilities.

House Bill #38This Bill requires mental hospitals and residential

centers covered by the Mental Health Patients’ Bill of Rights Act to report deaths and critical incidents to the State Protection & Advocacy Agency which is authorized by federal law to investigate such occurrences.

House Bill #37This Bill adds various protections to the Mental

Health Patients’ Bill of Rights Act, including safeguards in administration of restraint and requirement of an enhanced patient grievance system for DPC patients.

House Bill #36This Bill clarifi es the role of the Community

Legal Aid Society, Inc. (CLASI), designated for the past 30 years as Delaware’s Protection and Advocacy Agency pursuant to federal law, in protecting patients and residents in nursing and similar facilities. As a complement to the existing protective system operated by the Department of

Health and Social Services, CLASI is authorized to solicit and investigate reports of abuse, neglect, mistreatment and fi nancial exploitation in covered facilities. Finally, the Bill deters interference and retaliation against persons cooperating with such investigations.

House Bill #34This Bill creates a committee to assess deaths

of individuals receiving residential mental health services through the Division of Substance Abuse and Mental Health or funded private providers.

The purpose of the Committee is to assess causation; promote improvements in policies, practices, and the service delivery system; and reduce prospects for preventable deaths.

House Concurrent Resolution #2This Concurrent Resolution urges Congress

and the President of the United States to enact the National Health Insurance Act. The Resolution to be provided to the Delaware Congressional delegation and the President of the United States.

Environmental Issues

House Bill #24The purpose of this legislation is to ensure

that all hazardous waste generated in this State is treated, stored, or disposed of in a safe manner that is protective of public health and the environment, and according to all existing and future federal standards. The legislation is also designed to prevent hazardous waste generated in this State from being sent outside of the United States to countries where health and environmental standards may not be equal to standards in this country.

House Bill #70This Bill bans the use of covenants or other

restrictions to prohibit the installation of wind systems in Delaware and sets minimum requirements for such operations.

SenateSenate Bill #18

This Act removes the provision that participants in the Delaware Healthy Children Program pay a premium to participate, while allowing the Department of Health and Social Services to consider instituting minimal co-payments for health services in order to recover a portion of the revenue

that would be lost due to the absence of premium payments. Removing the premium payment may reverse declining enrollment in the Program and increase the number of children in Delaware who have health insurance coverage.

Senate Bill #17This Bill creates a statewide health insurance

purchasing pool to allow individuals and small businesses to obtain the most favorable premiums possible from the private insurance market.

Federal LevelHouse of Representatives

H. R. 448To protect seniors in the United States from

elder abuse by establishing specialized elder abuse prosecution and research programs and activities to aid victims of elder abuse, to provide training to prosecutors and other law enforcement related to elder abuse prevention and protection, to establish programs that provide for emergency crisis response teams to combat elder abuse, and for other purposes.

H. R. 1086To improve patient access to health care services

and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system.

SenateS. CON. RES. 6

Expressing the sense of Congress that national health care reform should ensure that the health care needs of women and of all individuals in the United States are met.

S. 4To guarantee affordable, quality health coverage

for all Americans, and for other purposes.

S.275 Children’s Health Insurance Program

Reauthorization Act of 2009–Amends title XXI (State Children’s Health Insurance Program) (SCHIP) of the Social Security Act (SSA) to reauthorize the program (referred to in this Act as CHIP) through FY2013 at increased levels. Passed by Both House and Senate

Sourceshttp://www.house.gov/http://legis.delaware.gov/

Key Legislative Issues to Watch

Page 8 • DNA Reporter May, June, July 2009

Kathy Sokola, MS RN CNE

Nursing programs across the country have expanded to address the nursing shortage. At the local level, the expansion of the nursing program at the Stanton campus of Delaware Technical & Community College (DTCC) has also been driven by the demands for more nurses in the health care system. With increasing numbers of students entering nursing many, new challenges have faced faculty and even greater emphasis has been placed on one of the most complex challenges for any nursing program. That challenge is retention. Like all nursing programs, DTCC strives to ensure that as many students as possible remain in the program, successfully graduate, and enter the professional work force. At Stanton, several initiatives have been implemented to assist with attaining this goal. These include the development of a retention coordinator position, a mechanism for identifying students at risk of failure, the institution of a supplemental instruction program, the creation of a nursing education internship program, and the engagement of students in creative learning strategies that address a diverse, multi-generational student body with varied learning styles.

One of the first initiatives to focus on the issue of retention was based on the realization that the highest attrition rates for nursing students occurred in the first level nursing courses. Our Student Issues Committee worked to identify factors predictive of student failure and then adapted an algorithm with permission from the works of Vicki Ann McDonald to guide interventions. At-risk students are identified by the Instructional Coordinator using established criteria as they enter the nursing program. The Instructional Coordinator then notifies the faculty advisor who follows the algorithm for making contacts with the student and selecting appropriate actions to assist the student based on the student’s progress and personal needs. Faculty advisors, Student Issues Committee, and the Retention Coordinator work collaboratively to monitor the progress of these students.

The position of Retention Coordinator was created to provide clinical nursing students with a resource person to assist them when they encounter problems that could affect their ability to successfully complete the nursing program. The Retention Coordinator maintains an active database of all students in the program and collaborates with faculty to monitor academic and clinical progress. In addition,

Facing the Challenge of Retentionthis faculty member assists students with math competency and test taking strategies and provides an open atmosphere for students to discuss personal issues that may impede success. The Retention Coordinator also has the responsibility for overseeing one of the major initiatives to increase retention – the Supplemental Instruction Program in Nursing (SIP-N).

SIP-N was based on the recognition that many nursing students require reinforcement of information to develop the confidence and skills needed to successfully complete the clinical nursing courses. Grant funding received from The Good Samaritan, Inc. Foundation in 2005 provided the stimulus for this program. Through SIP-N students have the opportunity to partake in free supplemental instruction each week. SIP-N sessions are arranged by the Retention Coordinator and are taught by practicing registered nurses, many of whom are graduates of the program. During these voluntary sessions, students bring questions about difficult material, and the instructors facilitate discussion around key concepts, helping students manage and interpret complex information. The sessions are designed to help students develop problem-solving and critical thinking skills that are necessary to successfully complete clinical nursing courses and that are essential in preparing for NCLEX-RN. To obtain the most benefit from SIP-N, students are encouraged to attend sessions on a regular basis. Through frequent participation, students have the opportunity to master class content in a timely manner. Students who attend three or more SIP-N sessions prior to an exam generally score higher than those who do not.

In addition to SIP-N, students may seek assistance and support from the nursing education intern. The Nursing Education Internship program was initially created to address the growing shortage of nursing faculty by generating an early interest in nursing education as a career choice among undergraduate students. The goal was to provide the opportunity for students to explore the teaching career while still a student in the nursing program. However, it serves an additional purpose in the area of retention. Students entering their last semester of nursing are eligible to apply for the internship position with faculty making the final selection. The intern mentors and supports students at the earlier levels through small group sessions that assist with mastery of course content through a structured tutoring program. This program has been very

popular. Some students prefer the smaller groups over larger numbers of students attending SIP-N, and other students use both programs as resources to help them be successful. Students relate well to having a peer who has experienced some of the same frustrations and hurdles providing first hand guidance. The interns receive monetary assistance for their participation through DTCC’s Peer Tutoring Program. The interns work closely with the Retention Coordinator and faculty members, who provide oversight for the program and resources for the interns.

The goal of retaining students has led to the development of several support groups to help students address unique issues and to foster networking. A Men in Nursing group, led by a male faculty member who is a former graduate, is an informal group that provides male nursing students with support and encouragement during their pursuit of a nursing career. The group promotes the positive image of men in nursing, offers academic and employment advice, and works collaboratively to promote men’s health in the community. An LPN Support Group was initiated after LPNs entering the program through advanced placement identified a need for assistance with the transition to the program and to the role of the student. A support group for international students is being investigated.

Initiatives to improve retention are also found in the classroom. Faculty has worked hard to address the various learning styles of students. A personal response system has been purchased and will soon be implemented to increase engagement of students in the classroom. The Campus Lab Coordinator has worked diligently to integrate high fidelity simulation into the curriculum, offering students a strategy for developing critical thinking and decision making skills under complex and realistic situations. The Campus Lab Coordinator has made Saturday morning lab hours available with a full time faculty member in attendance to assist students with skill acquisition. This is very popular with first semester students and helps with their socialization into the program. Home Health Care labs, Critical Thinking Simulations and the creative integration of technology offer students multiple modalities for learning according to their individual styles.

Through all of these efforts, the nursing program at DTCC Stanton campus is working to improve the retention of its nursing students. Faculty will continue to seek innovative ways to help students achieve success.

May, June, July 2009 DNA Reporter • Page 9

Christine Jarrell, RN, MSN

Christine M. Jarrell earned her BSN from the University of Delaware and her MSN from Wesley College. Christine has worked in acute care at Bayhealth Medical Center, as a Public Health Nurse for the State of Delaware, and as a manager of the Home Health Care Unit at Bayhealth Medical Center. She is currently the Coordinator for Learning Resources at Wesley College, Department of Nursing. In this role, she manages simulation activities and the skills competency-testing component of the BSN program. Christine was the designated nursing faculty member from Wesley College to attend the Safe Patient Handling and Movement Train the Trainer conference in March 2005. She coordinated the nursing department’s role in the research project to integrate Safe Patient Handling and Movement training into the BSN curriculum. Christine can be reached by email at jarrelch@wesley.edu or at her office number (302) 736-2497.

Since 2003, the American Nurses Association (ANA) has been an advocate for the implementation of safe patient handling work environments for all nurses. The position statement titled “The elimination of manual patient handling to prevent work-related musculoskeletal disorders” was approved by the ANA Board of Directors in June 2003.1 Many evidenced based articles have been published to support the need for widespread adoption of Safe Patient Handling and Movement (SPHM) practices.

Safe patient handling is the “application of evidenced based strategies to reduce the risk(s) associated with manual patient handling.”2 These strategies include the use of equipment, such as ceiling lifts, portable lifts, friction reducing devices, motorized stretchers, etc. as well as the staff education and ongoing support needed to assure that the equipment is used safely and effectively. Nursing staff must also be instructed on patient assessment criteria and the use of decision trees or algorithms to choose the appropriate equipment.

In the state of Delaware, acute care hospitals vary in the degree of formal integration of SPHM practices, staff education and equipment. Long term care facilities have incorporated the use of mobile lift equipment in their facilities for several years.

As recently as 2004, schools of nursing were still teaching proper body mechanics as the safe way to lift, move and transport patients, even though the nursing profession ranked high as an occupation with work related musculoskeletal disorders.3

Integrating the Concepts of Safe Patient Handling and Movement into a Nursing Curriculum

In the fall of 2004 an invitation to submit an application to participate in a research study titled “Development and evaluation of a safe patient handling and movement curriculum” was disseminated to schools of nursing throughout the United States. This research study was a joint effort between the ANA, the National Institute of Occupational Safety and Health, and the Veterans Integrated Service Network 8. The faculty of the Department of Nursing at Wesley College submitted an application and Wesley was chosen as one of 26 schools nationwide to participate in this research study.

In March 2005, nursing faculty members from the chosen schools attended the 5th Annual Safe Patient Handling and Movement Conference in Tampa, Florida. They received training during the general educational sessions and specific training on the required activities involved in the research study. In the spring and summer of 2005, Wesley completed the IRB approvals and reviewed the Foundations of Nursing (NR214) course content to allow for the time needed to include the pre-test, SPHM educational module, and post test. Several lifting equipment companies offered to participate in this study and were each assigned to specific schools of nursing. The companies delivered and installed their equipment over the summer.

In November 2005, students in the NR214 course completed the SPHM module. The nursing faculty also completed faculty specific pre-tests and post-tests. Students were enthusiastic about learning how to use the lifting equipment. One consistent comment in the module evaluation, however, was the disconnect between the principles of SPHM and what they were encountering as student nurses in the “real” world.

A subsequent study, titled “Faculty perceptions of implementing an evidence-based safe patient handling nursing curriculum module” was completed in 2007. In this study, participating nursing faculty identified two barriers to the inclusion of the SPHM concepts into a nursing curriculum. One barrier reported was “...the difficulty of fitting one more thing into an already crowded curriculum.”3 The other barrier “was the challenge of working with faculty colleagues who did not attend the train the trainer program and insisted on keeping the paradigm of relying on body mechanics as the primary means of preventing injury.”3 These barriers were not encountered at Wesley College.

At the end of the 2005-2006 school year, the Wesley nursing faculty discussed the appropriate placement of the SPHM concepts in the nursing curriculum and decided that a better fit would be to include this topic in the Health Assessment and Health Promotion (NR109) course, since the focus

of SPHM is a health promotion/injury prevention activity for nurses. It continues to be included in this course.

The nursing faculty chose to emphasize the importance of patient safety and prevention of musculoskeletal injuries in nurses. Thus, SPHM concepts should be interwoven into each level of the nursing curriculum at Wesley. This is the current plan: Freshmen receive an introduction to the concepts of SPHM and hands on instruction in the safe use of lifting equipment. In the sophomore year, a representative from the Christiana Care’s PEEPS program provides a mandatory in-service to students to meet the competency requirements of clinical affiliation with this agency. The junior nursing students have a dedicated skills day each spring. Groups of students are assigned a specific skill which they have already mastered. They are required to demonstrate and research this skill with an emphasis on patient safety, current regulatory or accreditation standards, risk management issues, and real world problems related to the actual day to day performance of the skill. Safe patient handling is always one of the skills included. Senior level students also must pass a final skills test and safe patient handling is included in this test.

In addition to course work, the students volunteer each year to offer a Girl Scout Badge in Nursing to brownies, junior, cadets, and senior girl scouts. One of the popular stations included in the badge workshop involves having the scouts learn to use the lifting equipment. In November of 2005, Wesley’s Tau Beta Chapter of Sigma Theta Tau International sponsored a conference on Safe Patient Handling and Movement. Junior and senior students in the undergraduate program and students in the graduate program participated in this conference.

The nursing faculty and students at Wesley College have not only incorporated the SPHM concepts into the nursing curriculum, but have truly embraced these concepts as a critical part of their nursing practice.

References1. American Nurses Association–Handle

with Care Backgrounder: ANA’s Advocacy on Ergonomics. Available at: http://n u r s i n g w o r l d . o r g / M a i n M e n u C a t e g o r i e s/O c c u p a t i o n a l a n d E n v i r o n m e n t a l /occupationalhealthhandlewithcare.aspx. Accessed February 27, 2009.

2. Nelson A, Baptiste A. Evidence-Based Practices for Safe Patient Handling and Movement. 2004 Online Journal of Issues in Nursing. Article published September 30, 2004.

3. Powell-Cope G, Hughes N, Sedlak P, & Nelson A. (2008). Faculty perceptions of implementing an evidence-based safe patient nursing curriculum module. OJIN: The Online Journal of Issues in Nursing. Article published August 18, 2008.

Page 10 • DNA Reporter May, June, July 2009

Michelle L. Collins, MSN, RN, BC

Michelle L. Collins earned her BSN and MSN from the University of Delaware. She is board certifi ed in Nursing Professional Development and has worked as a nursing educator for over 10 years. She is currently the Nursing Orientation Coordinator at Christiana Care Health System and works with nursing educators through out the organization to provide quality educational content and programming for nurses. She is also responsible for the oversight of all nursing and paramedic student clinical experiences within Christiana Care. Michelle can be reached by email at mcollins@christianacare.org.

The retention of graduate nurses (GNs) is crucial to hospitals’ survival as nursing workforce demands increase and retirement of the baby boomer nursing workforce looms (Altier & Krsek, 2006). Specialized internships or residency programs that extend the length of GN orientation and provide for additional educational classes are important retention tools. However, mentoring is a more universal retention tool as healthcare agencies that provide mentoring can potentially infl uence every nurse’s professional development as well as every GN’s transition to nursing practice. Parse (2002) described mentoring as “a moment-to-moment process that arises… when two or more presences engage in a dialogue about a scholarly opportunity or a career choice” (p. 97). Both of these defi nitions rely on nurses willingly supporting each other with long-term measurable outcomes in mind.

Hurst and Koplin-Baucum (2003) described the mentoring program at Banner Good Samaritan Medical Center as an 18-month support system for new registered nurses (RNs). A mentor was selected by the new RN upon completion of the three month precepted orientation. Mentors attended a six hour workshop during which the phases of the mentor relationship, program tools, and an overview on dealing with diffi cult situations were provided. Mentees were aided in their professional development by their mentors through facilitation of decision-making, role modeling behavior, evaluation of strengths, identifi cation of improvement opportunities, and participation in professional organizations. A database maintained by the program coordinator recorded the contact information for each participant and tracked the evaluation dates of each pair at each six-month program interval. The authors did not denote the total number of participants, the mentor selection process, or whether a mentor may be paired with more than one new RN. They indicated a 3.1% reduction in nurse turnover after one year. Anecdotal feedback from mentors revealed

their deeper sense of professionalism and mentees reported less social stress during their fi rst year of employment.

Wagner and Seymour (2007) indicated that “when guided by a caring framework of trust, commitment, compassion, and competence, mentoring [is] a caring action [that] builds healthy relationships and energizes environments” (p. 201). The authors described how Emerson Hospital, Fitchburg State College, and Middlesex Community College collaborated to provide a student nurse to RN mentoring program supported by the Nursing Career Ladder Initiative federal grant. The program’s goal was to improve the success rate of students at risk of failing through the infl uence of seasoned direct care nurses. It was marketed to the hospital’s nursing leadership team and its nursing councils. The program consisted of a workshop, mentoring activities for the student-nurse pairs, and monthly group meetings. Voluntary mentor applications were circulated by the hospital’s nurse managers; however, no professional criteria for acceptance were denoted by the authors. Selected mentors received an unspecifi ed stipend and paid workshop time. The college and hospital coordinators matched the mentor-mentee pairs based on their profi le forms which indicated their personal interests and experience level. Each pair was required to have monthly personal contact and electronic or telephone contact weekly. These communications were documented on a tracking tool that calculated the time spent and the status of the mentor-mentee relationship. Eleven of fi fteen students successfully completed the one year program.

Latham, Hogan, and Ringl (2008) described a three year relationship between one academic institution and two non-affi liated hospitals. The partnership focused on improving the nurse workforce environment through development of a mentoring program which was not specifi cally geared towards GNs. A steering committee identifi ed the criteria for mentor and mentee applications and created a website for monitoring the mentor-mentee teams which also contained a discussion forum, personal web pages, and mentoring newsletters. Two eight-hour education sessions were provided to: emphasize mentoring as a minimum one year commitment for the mentor and mentee, practice interpersonal skills, select pairs through review of personal web pages, review the partnership agreement, and develop mutual mentor-mentee goals. Mentors were provided paid class time with continuing education credits and they were invited to a two-hour nursing leadership meeting quarterly to share their concerns and recommendations for the program. A total of 92 pairs completed the program over the three years of the project. Program mentors were successful in supporting their fellow nurses and also improved the work environment as a secondary benefi t.

Christiana Care Health System (CCHS) has recently revitalized its RN mentoring program as another means of advancing our professional nurse development. A team of nursing educators formed in Fall 2008 to reconstruct a nurse mentoring program that was initially introduced in 2004. The

intent of the new program is to facilitate the GN transition to practice after completion of orientation, foster the professional development of novice RNs, and support RNs experiencing a role transition. The team developed a short mentor profi le for each volunteer to complete. The minimum criteria include a minimum of one year RN experience at CCHS, exhibiting specifi c values, being a respected team member, being fl exible and reliable, and having been a preceptor of students and/or newly hired nurses within the past 2 years. Applicants must be willing to commit to mentoring another nurse for a minimum of 12 months. Nursing staff development specialists and nurse managers review each of the RN applicants to determine eligibility.

Mentees will be paired with their unit-based mentors through individual selection using the CCHS nurse mentoring website. Mentors will participate in a four-hour interactive education session they receive before initial mentee contact. Mentor-mentee pairs are expected to set developmental goals and meet once per quarter minimally. Mentor-mentee activities are based on short term objectives to meet the mentee-identifi ed developmental goals. These activities will be tracked over the course of the program.

A thorough understanding of the mentoring process is essential for implementing a successful mentoring program. Successful mentors display patience, enthusiasm, knowledge, and respect while successful mentee characteristics include openness to constructive feedback, a strong career commitment, and personal drive (Kanaskie, 2006). Effective mentors can be the professional impetus that many nurses need to continue their professional development in assuming advanced roles in nursing practice, education, administration, or research. Higher job satisfaction, personal and professional growth, and improved socialization to hospital culture are some of the many benefi ts of mentoring (Dyer, 2008).

ReferencesAltier, ME, & Krsek, CA. Effects of a 1-year

residency program on job satisfaction and retention of new graduate nurses. JNS. 2006;22: 70-77.

Dyer L. The continuing need for mentors in nursing. JNS. 2008;24: 86-90

Hurst S & Koplin-Baucum S. Role acquisition, socialization, and retention. JNSD. 2003;19: 176-180.

Kanaskie ML. (2006). Mentoring: A staff retention tool. Critical Care Nursing Quarterly. 2006;29: 248-252.

Latham CL, Hogan M, & Ringl K. Nurses supporting nurses: Creating a mentoring program for staff nurses to improve the workforce environment. Nursing Administration Quarterly. 2008; 32: 27-39.

McKinley MG. Mentoring matters: Creating, connecting, empowering. AACN Clinical Issues. 2004; 15: 205-214.

Parse, RR. Mentoring moments. Nursing Science Quarterly. 2002; 15: 97.

Wagner, AL, & Seymour, ME. A model of caring mentorship for nursing. JNSD. 2007; 23: 201-211.

Mentoring: The Continuation of Professional Development

Michelle Collins

Visit us on the web Visit us on the web Visit us on the web Visit us on the web Visit us on the web Visit us on the web anytime atanytime atanytime at

www.denurses.orgwww.denurses.orgwww.denurses.orgwww.denurses.orgwww.denurses.orgwww.denurses.orgwww.denurses.orgwww.denurses.orgwww.denurses.org

May, June, July 2009 DNA Reporter • Page 11

Kate Salvato, MSN, RN, NEA-BC

Kate (Catherine) Salvato e a r ne d he r nu r s i n g diploma from Thomas Jefferson University, School of Nursing. After competing her BSN and MSN from the University of Delaware she specialized in Nursing Education and Nursing Administration. She is a board certifi ed Advanced Nurse Administrator with over 32 years of nursing exper ience. Current ly, the Director of Education at Bayhealth Medical Center she is responsible for Staff, Patient and Consumer Education. Kate can be reached by email at catherine_salvato@bayhealth.org or at her offi ce at (302) 744-7188.

Standardizing the colors for patient alert wristbands has improved patient safety in health care facilities. In 2005, the Pennsylvania Patient Safety Authority (PPSA) issued a patient safety advisory that received national attention. A near-miss incident occurred in a Pennsylvania hospital when a nurse mistakenly placed a wrong colored wristband on a patient. The nurse applied a yellow wristband with the intent to identify the patient’s “restricted limb”. Unfortunately, in this hospital, a yellow wristband indicated a do not resuscitate (DNR) order. In a nearby hospital, where the nurse also worked, a yellow wristband was intended to identify a “restricted limb”.1 Four months later, a hospitalized patient with a known prior anaphylaxis due to a latex allergy was provided with a green wristband—a warning sign for latex allergy. During his hospital stay he was transferred to an ambulatory diagnostic center for a test. The staff at the center was not familiar with the signifi cance of the green bracelet and the warning of latex allergy. The procedure was conducted with latex gloves and the patient experienced an anaphylactic reaction that required medical intervention to correct the life-threatening situation.4 Although no lasting harm occurred to these patients, the near-misses became the hallmark events which led to a survey revealing a wide variation in colors and meanings in a group of hospitals. Suddenly, the opportunity to improve patient safety became palpable and the need for action obvious.1,6

After the PPSA announced the near-miss incident, the dangerous consequences due to the lack of standardization were exposed. Numerous hospitals and ambulatory surgery centers in several states began to assess the obvious confusion created when colors were not consistent among the healthcare facilities. The states which participated in this initial assessment process included Colorado, Missouri, Arizona, New Mexico, California, Nevada, Oregon, Utah and Oklahoma.2, 5

Implementing Standardized Colors for Patient Alert Wristbands

Kate Salvato

As with many national initiatives, the call for standardization of colored wristbands has its detracters. The Patient Safety Advisory argued that the use of color-coded patient wristbands created unnecessary risk. When wristbands are used to convey medical information errors commonly occur. Clinicians may not notice wristbands and may provide treatment inconsistent with the patient’s condition or preferences. Additionally, wristbands may be temporarily removed during medical procedures and not be replaced. Wristbands may be applied in error such as in Pennsylvania’s landmark case. Suggestions made to minimize error, should colored-wristbands be adopted by a health care facility, include:3

• Limit the number of colors in use on patient wristbands.

• Standardize the meanings of specifi c colors among health care facilities.

• Use only primary and secondary colors• Use brief, pre-printed descriptive text on the

wristband to provide clarifi cation to clinicians.• Emboss or pre-print text. Handwriting

on wristbands should only be done in an emergency.

• If your facility uses wristbands for pediatric patients that relate to the Broselow color-coding system for pediatric resuscitation carts, consider the potential for confusion between the Broselow bands, most likely used in the Emergency Departments, Pediatrics, and Neonatal Intensive Care, and the other colored-wristbands your facility uses.

• Explain to the patient and/or families the purpose of all wristbands. This provides an opportunity for errors to be identifi ed. This also reinforces the facilities commitment to promoting a culture of safety by encouraging patients and their families to participate in efforts to prevent errors.

• Ask patients to remove the social-cause bracelets that are popular today by explaining the confusion to staff and unsafe situations for patients who refuse to remove the social-cause bracelet.

• Staff should periodically reconfi rm with the patient and family the meaning of the colored wristbands and the goal for creating a safe patient environment.

• Consider making wristband verifi cation part of the nursing assessment during shift change.

• Write clear and concise policies and procedures that outline who has the responsibility and authority to place and remove all wristbands on patients and that all staff have a role in making sure any errors or omissions are quickly corrected.

Of course, these statements can be viewed as barriers as to why you should beware of moving forward with this safety initiative. However, they could also be interpreted as pitfalls to avoid when your facility decides to implement the standardized colors for patient alert wristbands.

Healthcare facilities contemplating the implementation of standardized colors for patient

alert wristbands as a patient safety initiative may fi nd the following process useful. Begin by defi ning your facility’s location in comparison to your peer organizations. Does your facility share borders with several states? Facilities that reside in close proximity should consider if their patient population is likely to transfer between Delaware, New Jersey, Pennsylvania, or Maryland as your care delivery processes might benefi t from this safety initiative. Next, consider the position statements and recommendations from the national associations that govern your practice. The American Organization of Nurses Executives (AONE), a subsidiary of the American Hospital Association (AHA), affi rms that America’s hospitals are committed to delivering safe care. As the national advocate for America’s hospitals, the AHA is asking all hospitals to consider using three standardized colors for patient alert wristbands. The colors, which have been adopted as a consensus in numerous states are: red for patient allergies; yellow for risk to fall; and purple for do-not-resuscitate patient preferences.1

The AHA also reminds hospitals that the colored wristband is an alert and the patient status should always be verifi ed with information from the patient’s chart. Communication with the patient and the patient’s family is critical for the success of your safety initiative. Designated staff should be involved in the process to explain the importance and meaning behind the standard colors for patient alert wristbands. The importance of a nurse who can act as the teacher and discuss the risk associated with the patient’s wearing of social-cause bracelets while an inpatient cannot be minimized. Finally, the organization must be willing to commit both time and fi scal support for the education of all employees who participate in patient care activities. This includes the Environmental Service worker who spies a yellow wristband and understands that this patient is at risk to fall or the anaphylaxis reaction that is averted because the technician participating in a procedure has identifi ed the green wristband and knows to provide a latex free environment for this patient.

References:Feldpush B. Implementing standardized colors for

patient alert wristbands. American Hospital Association. 2008; 1-4.

ECRI, ISMP. Use of color-coded patient wristbands creates unnecessary risk. P. 2005;2:1-4.

FDA. Important new information–dangerous confusion with color coded wristbands. FDA patient safety news. 2006; 7-8

Ray L. Use of colored wristbands from hospital patients in Oregon. Oregon pt safety commission. 2006; 1-5

Wristband color standardization. Colorado Foundation for Medical Care. AHRQ. Identifi cation of inpatient dnr status” a safety hazard begging for standardization.

Hampton K. Standardizing colored wristbands improves patient safety. Strategies for Nurse Managers. Feb 2008.

Position Term

President-Elect/ ANA Delegate Four-year commitment—one year as President- Elect followed by two years as President and one year as Past-President.

Three (3) ANA Delegates, one Two-year termfrom each county.

Secretary Two-year term

Three (3) members of the Committee Two-year termon Nominations, one from each county.

To self-nominate or nominate a colleague, visit the DNA website: www.denurses.org, click on “about” tab for consent to run form and information on each of the positions.

Call for Nominations for Elective Office2009 Elected Offices Available

Page 12 • DNA Reporter May, June, July 2009

Lucille C. Gambardella, PhD, RN, CS, APN-BC, CNE

Dr. Lucille Gambardella earned her BSN at Villanova University, MSN at Boston University, and PhD at Columbia Pacifi c University. She is Chair and full professor at Wesley College and her nursing career has spanned over 40 years as a nurse educator and clinical specialist in psychiatric/mental health nursing. Lucille recently completed service as President of the Delaware Board of Nursing and is a former vice-president and president of the Delaware Nurses Association. She is also an accreditation visitor for the National League for Nursing Accrediting Commission, the Middle States Commission on Higher Education, and she is a speaker at professional conferences both nationally and internationally on topics related to nursing education and educational leadership. Dr. Gambardella can be reached by e-mail at gambarlu@wesley.edu or at her Wesley offi ce at (302) 736-2512.

The nurse educator role has not always been considered an advanced practice role. It is a relatively new concept endorsed by both the National League for Nursing (NLN) and by the American Association of Colleges of Nursing (AACN). Each of these professional organizations indicates support of this idea in different ways, but the essential element of the scholarly preparation and recognition of the specialization of the nurse educator role is clear.

The NLN began the certifi cation process for nurse educators in 2005. This certifi cation is considered

Nurse Educator: Clearly an Advanced Practice Rolea mark of professionalism and establishes nursing education as a specialty area of practice at the advanced level (NLN, 2008). It further creates an opportunity for nurse educators to demonstrate their expertise and skill in the educator role. (www.NLN.ORG) In fact, the mission of the Academic Nurse Education Certifi cation Program is to recognize excellence in the advanced specialty role of the academic nurse educator (NLN, 2008). NLN defi nes the core competencies required for achievement in this advanced role and clearly relates these competencies to the theoretical and practical knowledge necessary to achieve the certifi ed status and be recognized as an expert in the specialty fi eld.

NLN further recognizes the excellence of the nurse educator advanced role through its initiative of the Academy of Nursing Education. The fellows chosen for the Academy are visionary nurse educator leaders who have contributed to nursing education in a sustained and signifi cant manner (NLN, 2009). The academy accepted its third class of fellows this past September.

The AACN has likewise made signifi cant effort to elevate the status of the nurse educator role. Its comprehensive web-based program called the Education Scholar (www.educationscholar.org) is an opportunity to advance one’s teaching skills, professional scholarship, and improve instructional capability (AACN, 2008). Modules in the program span topics that include, for example, Facilitating Learning in the Classroom, Problem-based Learning, Learning in the Experiential Setting, and Promoting Teaching and Learning Excellence in your Institution. (AACN, 2008) Similar to the NLN, AACN is committed to the art and science of teaching and to the advancement of teaching excellence.

In this author’s opinion, recognition of the nurse educator as an advanced practice role is a fi rst step in the resolution of the nurse faculty shortage. Viewing the classroom and clinical learning environments as practice arenas is a natural process in understanding the nurse educator role and in recruiting students to graduate programs that focus on the leadership and advanced skills needed for the nurse educator role. At this time, nursing specialties that are laden with

high technology skills and high drama are popular with those choosing to attend graduate school. Ask any nurse educator in practice today and they will tell you that the classrooms and clinical sites in nursing education at all levels are fi lled with both! Personally, this author can tell you that even after thirty-seven years in the classroom, there is seldom a day that drama or the need for high technology does not occur and surely any readers who are nurse educators will concur.

The nursing profession is in the midst of a perfect storm the affects the future of health care and the education of new nurses. This storm, characterized by the nursing shortage in general, the aging of our population, the aging of our nursing workforce–particularly the nurse educator workforce, the lack of clinical teaching sites, the wide array of educational choices for the best and brightest of our high school graduates, and the limited number of graduate students choosing the nurse educator role are all merging to create a crisis situation. Solutions to this growing crisis are not easy, and the best minds in nursing across our nation and indeed across the world, have been working toward viable options that will bring about effective outcomes.

In Delaware, the commitment to enhance the nurse educator role and to contribute to resolving the shortage of nurse faculty is evident in the efforts made in our institutions; the University of Delaware, Wesley College, and Wilmington University all have programs to prepare the graduate level prepared nurse for the nurse educator role. Options range from a weekend post-master certifi cate program to MSN programs with a specialty focus in the nurse educator role. This author would encourage the reader to consider the nurse educator role as an area of advanced practice. The top reason that thousands of qualifi ed applicants are turned away from 4 year institutions to study nursing is the lack of faculty (62% of schools, responding) to prepare them (AACN, 2009). If the nursing shortage is to be resolved, the nurse faculty shortage must be resolved as well. The time has come; the time is now. Consider the nurse educator role.

Lucille Gambardella

Tracy Patrick-Panchelli, BSN, RN-BC, CPN

Tracy Patrick-Panchelli is the Coordinator of Nursing Continuing Education at Nemours/Alfred I. DuPont Hospital for Children. She earned her Bachelor of Science in Nursing degree from the University of Pennsylvania in 1993 and her diploma in legal nurse consulting in 2001. She is a certifi ed pediatric nurse. She is also board-certifi ed in Nursing Professional Development and is a frequent lecturer on a variety of nursing practice topics.

If what one doesn’t know might hurt them, we should all be worried. And so it is with nursing and the need to assimilate rapid, ongoing change. Fortunately, our profession offers an infi nite array of possibilities to help us both insulate and advance ourselves. All we have to do is seek them out, knowing that our skills and knowledge, repeatedly agitated and combined with others like clothes in a washing machine, will produce ongoing curiosity, problem-solving strategies, and an expanded worldview.

As a novice nurse in an 800-bed tertiary care hospital in New York City, I was struck almost immediately by a perceived lack of readiness for the job. I was tempted to wonder how my baccalaureate education could have prepared me so poorly as I saw my peers who had trained in diploma programs run circles around me starting IVs and giving injections. What if all those hours in the library writing papers couched in nursing theory were a waste? Experience and practice, I soon learned, gave me the confi dence with the technical skills. It wasn’t until years later that the foundation for professionalism and leadership in nursing, set in place during my undergraduate education, became recognizable.

Two years into my nursing career, I ventured into pediatric critical care nursing, a newly acquired area of interest. It quickly became apparent that I did

understand the bigger picture of my patients’ clinical conditions and that I had in fact gained signifi cant experience. Immersed in an environment of excellence in clinical care and very high expectations of its practitioners, though, I felt challenged. How could I improve myself? Contribute to my unit? And defi ne success? Certain goals were prescribed and encouraged and ended up being checked off the list over the next several years. These included joining a professional association, earning specialty certifi cation, advancing on the clinical ladder, and developing a professional portfolio. I gained exposure to the coaching-mentoring role by precepting new nurses and working with nursing students. I also enjoyed opportunities to share my expertise by teaching in nursing orientation, continuing education programs and certifi cation review courses. Eventually, becoming a team leader gave me a sense of accountability for not only my own practice, but for that of my peers.

Having received positive peer and manager feedback on my analytical skills, I looked for opportunities to apply them to income-generating work while decreasing my hospital work hours in order to care for young children at home. Legal nurse consulting seemed a natural fi t and I pursued distance education in this specialty, eventually earning a diploma in 2001. Starting my own business was a skill set I did not possess, so I sought out resources everywhere I could. Ultimately, it was membership in the American Association of Legal Nurse Consultants and the Philadelphia Chapter of this organization that proved the biggest boon. It was there that I found a network of collegial, supportive nurses who were willing to share their knowledge, help me get started and provide guidance along the way. Reviewing medical malpractice cases for defense and plaintiff attorneys and testifying as a nursing expert quickly became my niche and I have been satisfi ed with my efforts to grow my business. Ongoing engagement in AALNC led to opportunities to edit the revised core curriculum, be a peer reviewer for a new legal nurse consulting course, and to get involved with the Philadelphia Chapter Board of Directors. Today, as President of the Philadelphia Chapter and a practicing independent legal nurse consultant, I am privileged to be able to contribute to the advancement of this specialty and to have a unique perspective on the work of clinical nursing.

Moving out of clinical nursing for the fi rst time in

2002, I arrived at Nemours/Alfred I. duPont Hospital for Children hungry for the opportunity to focus on teaching and took on the role of clinical nurse educator. Earning national certifi cations in pediatric nursing and in nursing professional development validated my increasing knowledge base and elevated my sense of professionalism for myself as well as my colleagues. This role allowed me to better understand what nurses need to prepare for a future of increased information, increased technology, and increased complexity of care. It was here that I was fi rst given the opportunity to attend a national conference and encouraged to present a poster. Expectations of my participation in hospital-wide committees soon came. These meetings afforded me the ability to network with colleagues in other disciplines as well as nurse leaders and to collaborate with them to monitor trends in healthcare and their anticipated impacts on nursing care. I soon realized that my view of nursing as a profession and its integral role in the healthcare environment was broadening, entreating all nurses to be engaged in the process of improving care and care systems.

I have now been a nurse for fi fteen years. My current role as Coordinator of Nursing Continuing Education combined with part-time work as a Critical Care Transport Team nurse and my legal consulting work demand multiple different skill sets. Unable to latch onto what I really want to be when I “grow up”, I am choosing to pursue graduate education in order to broaden my horizons and increase the potential for additional career opportunities. But with so many options available, I had no idea where to start. After considering different master’s tracks in nursing, I ultimately matriculated in Villanova University’s Master’s in Nursing—Health Care Administration program. With a broad-based curriculum including courses in health policy and leadership strategies, I am hoping to enhance my ability to create and sustain changes that will benefi t nursing practice.

Nursing education is the foundation for starting in and growing within the profession. In order to develop our careers and also be prepared during uncertain times, commitment to lifelong learning is essential. Looking for opportunities to diversify one’s skills is another career development strategy. And fi nally, not being afraid to take risks and volunteer to try something you’ve never done before can not only teach valuable skills, but also help to build one’s network of professional colleagues.

If Nursing is a Sea of Possibilities, Why Am I Still Adrift?

Tracy Patrick-Panchelli

May, June, July 2009 DNA Reporter • Page 13

Delaware Cultural Competency

Education Series

Education Series sponsored by:

Delaware Division of Public Healthin partnership with the

Delaware Academy of Family Physicians

and Delaware Nurses Association

Upcoming Session Dates:

May 7, 2009—Georgetown (8:00am–10:00am) Registration begins at 7:30am

Topic: Cultural Competence in Health & Social Services Del Tech & Community College (Owens Campus) Seashore Highway, Rt. 18, Georgetown, DE

Speakers: Horace M. DeLisser, MD, University of PA Marlene Saunders, DSW, MSW DSU, College of Health & Public Policy

*Continental breakfast served

May 19, 2009—Newark (8:00am–10:00am) Registration begins at 7:30am

Topic: Creating a Culturally Sensitive Health Care Environment John Ammon Education Center Christiana Care Health Systems 4765 Ogletown-Stanton Road, Newark, DE

Speakers: Ana E. Núñez, MD Drexel University College of Medicine Marcos Pesquera, RPh, MPH Adventist HealthCare, Inc.

*Continental breakfast served

D E L A W A R E C U L T U R A L C O M P E T E N C Y E D U C A T I O N S E R I E S

Goal

This series of workshops will increase the cultural competence of health care professionals and organizations by raising awareness of cultural issues that impact the delivery of health services and providing strategies that improve health outcomes.

Learning Objectives

At the conclusion of each session, participants will:

Understand the central role of cultural competence in the provision of quality health care to diverse populations

Learn effective cultural communication strategies that enhance trust between patient and health care provider

Understand how cultural differences between patient and provider affect the patient-provider relationship

Learn practical methods to address cultural challenges faced when caring for diverse patients

Who Should Attend:

Physicians Skilled and service workers

Nurses Community Health Centers

Social workers Students

Community-based/Non profit workers

The Cultural Competency Education Series is being developed by the Delaware Division of Public Health in partnership with the Delaware Nurses Association and the Delaware Academy of Family Physicians.

Supporting Agencies:Chi Eta Phi Nursing SororityDSU, College of Health and Public PolicyDel Tech School of Nursing National Social Workers Association, DE Chapter

For More Information, please contact:Event CoordinatorSocial Solutions LLC(302) 239-4666socialsolutions1@gmail.com

ACCREDITATION STATEMENTApplication has been filed with the American Academy of Family Physicians. Determination

of credit is pending. The Delaware Nurses Association is accredited as a provider of

continuing nursing education by the American Nurses Credentialing Center’s Commission on

Accreditation.CME/CEU credit hours available.

Education Series sponsored bythe Delaware Division of Public Health

Pre–Registration Required

Name __________________________________________________________________________________________________

Address ________________________________________________________________________________________________

Phone# ________________________________ E-mail ______________________________________________________

____ Individual sessions Total fee enclosed $ _________________________ $15.00 General Public Dates (if signing up for individual sessions) ____ $5.00 for residents & students _________________________________________________ DAFP / DNA / NMA Members (Complimentary) _______________________________________________ NASW Members

Mail to: Delaware Nurses Association5586 Kirkwood Highway • Wilmington, DE 19808 CME/CEU credit hours available.(800) 381-0939 • (302) 998-3141 (Phone) • (302) 998-3143 (Fax)

Visit www.denurses.org to register online.

E N R O L L M E N T F O R M - D E L A W A R E C U L T U R A L C O M P E T E N C Y E D U C A T I O N S E R I E S

Purpose

The population of the United States is becoming increasingly diverse. By the year 2050, the majority of the nation’s residents will be minority. Because healthcare organizations and providers

are challenged with responding to the needs of individuals with culturally diverse values, beliefs, and behaviors, a series of workshops will be scheduled for the purpose of building a culturally competent healthcare system in Delaware.

Page 14 • DNA Reporter May, June, July 2009

Nominations are open for nominations for the following positions on the Board of Directors for the Delaware Nurses Association.

1. President-Elect—This posit ion ser ves concurrently as an elected ANA Delegate. The President-Elect works in close collaboration with the President and actively participates in committees of the DNA. This is a one (1) year term until the president position is assumed. The president’s term is for two (2) years with an additional one (1) year as past-president.

2. Vice-President—In the absence of the President, assumes the duties of the President. This person is responsible for any duties assigned by the Board of Directors and/or President. This is a two-year term.

3. Treasurer—The Treasurer is required to monitor and report on the finances of the association to the Board. The treasurer also reports on the finances at the general membership meetings. This is a two-year term.

4. At Large Director/Alternate ANA Delegate (2 positions) The Alternate assumes the duties of the delegate in the event that the delegate is cannot attend the national House of Delegates. This is a two-year term.

Eligibility Requirements for CandidatesEach candidate1 must be a member of the

Delaware Nurses Association in good standing. Interested members should have some experience participating in the organization. Full Members as defined in the Association bylaws is described as:

1. A person who has been granted a license to practice as a registered nurse in at least one state, territory, possession or the District of Columbia in the United States, and who does not have a license under suspension or revocation in any state, territory, possession or District of Columbia in the United States.

2. A person who has completed a nursing education program that qualifies the applicant to take a DNA-accepted nursing board examination for registered nurse licensure as a first time writer.

3. Membership is unrestricted by consideration of age, creed, disability, gender, health status, lifestyle, race, nationality, religion, or sexual orientation.

Work of the Board of DirectorsThe Board of Directors, a corporate body composed

of elected members, serves as the agent for members of the DNA. Each member of the Board must uphold the mission, vision and goals of the Association. The functions of the Board include but not limited to the following2:

1. Exercise the corporate responsibility and fiduciary duties of the Association with applicable provisions of law.

2. Provide for implementation of action and directive of DNA membership.

3. Establish policies and provide for the transaction of business and coordination of association activities in the interim between the general membership meetings.

4. Provide for adoption of financial policies.

Role of the Board of DirectorsMembers of the Board of Directors are the leaders

of the Association. They are responsible for ensuring that all decisions are made in the best interests of the Association. They must ensure that the Association will be handed on to succeeding generations with its strengths intact or improved, and its mission, vision and goals well supported.

Time CommitmentMeetings of the Board of Directors shall be held

at least four (4) times annually at a time and place determined by the Board of Directors. Candidates should be able to attend board meetings as called

Delaware Nurses Association Consent to Run

Consent to Run

I give consent to have my name placed in nomination for an elected position for the Delaware Nurses Association. If elected, I will be free to fulfill my commitment as defined by the DNA bylaws and will be available to attend meetings.

Signature _________________________________________________________________

Date ______________________________________________________________________

Name (please print) _______________________________________________________

Address __________________________________________________________________

___________________________________________________________________________

Phone (work) ______________________________________________________________

(home) ____________________________________________________________________

Please supply the following information to be printed and distributed to the membership prior to the elections. Please include an electronic photo that will be printed with your brief biography.

Educational Preparation:

Current Employer:

Current Position:

Employment background in nursing:

Current or previous DNA involvement:

Position statement (75 words or less):

Please contact the Delaware Nurses Association with any questions at (302) 998-3141.

by the president, general membership meetings, and national meetings (as applicable for the position). Special meetings and ad-hoc committee assignments would be in addition to those commitments. Added time commitments vary depending on the depth to which individual issues are pursued.

Nomination ProcedureNomination forms are available on the Delaware

Nurses Association website (www.denurses.org). They are also available from the Delaware Nurses Association, 5586 Kirkwood Highway, Wilmington, Delaware 19808. To request a form by phone, call (302) 998-3141 or (800) 381-0939.

The onus is on the person nominated to submit a bona fide nomination form. That is, the candidate is responsible for ensuring that the form is complete and that the appropriate documentation has been provided.

All nominations are subject to a verification process by the Chair of the Nominating Committee. A nomination will be certified as correct only if all the following criteria are fulfilled:

1. The Candidate is a member of the Association in good standing.

2. The nomination form includes the candidate’s name, his/her consent to run.

3. Candidate information is completed as instructed on the pages provided.

4. The completed nomination form is received by the Delaware Nurses Association 5586 Kirkwood Highway, Wilmington, Delaware 19808, by 4:00 p.m. on Friday, October 16, 2009. Forms received after that date will not be considered.

1. Special, Associate and Honorary Members are eligible for candidacy. Criteria for each membership are outlined in the Delaware Nurses Association bylaws under Article V, Section 2.

2. For full explanation of the functions of the Board of Directors can be found in the Delaware Nurses Association bylaws under Article VIII, Section 6.

May, June, July 2009 DNA Reporter • Page 15

Dot Baker, RN, MS(N), CNS-BC, EdDProfessor, Nursing, Wilmington University

Nursing Education: A thesaurus inventory for the term “educate” revealed a plethora of primary and supportive action verbs. Primary verbs such as educate, inform, instruct, school, train, tutor, alert, coach, and edify indicate rather powerful initial and ongoing actions. Supportive verbs suggest broad, deep, and ongoing actions to support education as a

continuous process. Here are the lists:

Primary Supportive Verbs Verb

educate educate, lecture, explain, show, demonstrate, clarify

inform tell, update, enlighten

instruct teach, train, coach, education, inculcate

school train, educate, teach, prepare, instruct

train teach, coach, educate, instruct, guide, prepare, tutor, school, exercise, work out, keep fi t, aim, direct, focus

tutor teach, educate, instruct, coach, train, lecture

alert warn, forewarn, notify, tell, inform

coach teach, train, prepare, instruct, tutor, drill

edify enlighten, inform, educate, instruct, improve, teach

Nurses are both obligated and privileged to educate themselves and their constituents. As educators, nurses must continuously be curious—to raise questions about their practice, profession, interests, and prospects. Nurses must be active and proactive to be aware, fi nd, employ, and communicate a variety of methods and resources to fulfi ll knowledge and education needs. Nurses must also serve as writers, reviewers, editors, researchers, etc. in order to contribute to and advance nursing information and resources. Nursing is dynamic—thus nurses as educators must precede and supersede those dynamics so that we are superlative role models in and for our profession.

This column features a variety of resources that we can use to fi rst educate ourselves. Then, nurses have quintessential opportunities to ignite a spark of natural and necessary curiosity at many levels (i.e., among ourselves, clients, families, colleagues, students, organizations, and local and global communities). We can fuel that spark and perpetuate lifelong learning as we enact our obligations and privileges as nurse educators.

LISTSERVS–electronic subscriptions that automatically deliver to your e-mail

American Nurses Association (ANA) @ http://www.nursingworld.org/ members can subscribe to the daily “SmartBrief” listserv which summarizes and links to top story news; nursing, health, and medical science; trends & technology; legislative policy and regulatory news; work/life balance; ANA news; and SmartQuote. Recent examples of contents include: more RNs get MSN degrees, exposure to workplace solvents may increase risk of lymphoma, secondhand smoke raises risk of dementia, few women adopt healthy practices before pregnancy, ICU nurses seek balance between emotions & education, N.J. residency program helps single moms become nurses.

Agency for Healthcare Research & Quality (AHRQ) @ http://www.ahrq.gov/ offers multiple listservs: (1) Health Information Technology listservs (2) Patient Safety Network (3) Talking to Consumers about HealthCare Quality (4) Morbidity & Mortality on the Web (Web M&M) (5) Research Activities (online newsletter) with most current fi ndings about areas

Data Bits

Dot Baker

Data Bits continued on page 16

Professional & Resource Organizations offer education via newsletters, reports, position & white papers, programs, services, interactive tools, continuing education, & listservs. Examples include:

Emergency Nurses Association (ENA) http://www.ena.org/

Oncology Nurses Association (ONS) http://www.ons.org/

National Association of School Nurses (NASN) http://www.nasn.org/

American Association of Colleges of Nursing (AACN) http://www.aacn.nche.edu/

National League for Nursing (NLN) http://www.nln.org/

American Heart Association (AHA) ht tp://w w w.a mer ica n hea r t .org/presenter. jhtml?identifi er=1200000

American Cancer Society (ACS) http://www.cancer.org/docroot/home/index.asp

Sigma Theta Tau International (STTI) http://www.nursingsociety.org/default.aspx

Joint Commission (JC) http://www.jointcommission.org/

such as primary care, longterm care, managed care, mental health, patient safety & quality, minority heath, child/adolescent health, women/men’s health, preventive health, chronic disease, costs & fi nancing, etc.

AHRQ’s Health Care Innovations Exchange @ http://www.innovations.ahrq.gov/ profi les new ideas to improve patient care delivery. The innovations are carefully described and evidence-rated.

Learn and Network connects users to literature, guest perspectives, Webinars, and podcasts.

MULTIPLE INFORMATION MEDIA–reports, newsletters, audiovisuals, training guides, health information, clinical trials, professional organization resources

Robert Wood Johnson Foundation (RWJF) @ http://www.rwjf.org/

Program areas: building human capital, childhood obesity, healthcare coverage, public health, vulnerable populations, quality/equality, pioneer/innovative solutions.

(1) Newsroom releases audio, video, articles, and commentaries. For example, Feb 2009–report about how tobacco companies have increased marketing toward women and girls. (2) Publications include journal articles, reports, policies, books, grant results, meeting highlights, toolkits. (3) Subscribe to e-mail updates @ http://www.rwjf.org/services/updateemail.jsp. News Digests, Advances (monthly report on projects & progress), Content Alerts about publications in topics of your choice, Synthesis Project (issue briefs, research reports). RWJF work in areas such as: addictions, palliative care, longterm care, medical malpractice, nurses & nursing, obesity, etc.

American Hospital Association (AHA) @ http://www.aha.org/. Advisories, news releases, databases, subscriptions to newsletters, management, and network information

American Association for Longterm Care Nursing @ http://www.ltcnursing.org/. Education resources @ http://www.ltcnursing.org/education/educationalresources.html

For example: trainer guide for longterm care educators, patient safety resources, fall risk reduction toolkit, results of longterm care leader survey

Mayo Clinic home page and link to subscribe to a newsletter @ http://www.mayoclinic.com/

Johns Hopkins Health Information Publications @ http://www.johnshopkinshealthalerts.com/alerts/

Clinical Trials.gov–search for clinical trials, obtain investigator instructions and background & links to other consumer health information from the National Institutes of Health @ http://clinicaltrials.gov/

Medline Plus®–search for information about health topics, drugs & supplements, news. Features interactive tutorials, surgery videos, senior health,

focus topics such as children’s dental health month and eating disorders @ http://medlineplus.gov/

Occupational & Safety Health Administration (OSHA)–features hospital e-tool with safety modules in multiple areas (e.g., administration, clinical services, emergency, housekeeping, ICU, pharmacy, surgical suite, healthcare wide hazards) @ http://www.osha.gov/SLTC/etools/hospital/index.html

Nursing Center.com @ http://www.nursingcenter.com/home/index.asp offers numerous resources such as news updates, readings, learning center, webcasts, and continuing education.

AHRQ—list of health services research @ http://www.ahrq.gov/news/pubcat/c_hsrv.htm

SIMULATION education– Using simulation education for undergraduate

education @ http://www.ncbi.nlm.nih.gov/pubmed/15673172

Simulation as teaching strategy for nursing education & orientation in cardiac surgery @ http://ccn.aacnjournals.org/cgi/content/full/24/3/46

Simulation Education & Training Center (SimET) @ Banner Good Samaritan Medical Center [videos] @ http://www.bannerhealth.com/Locations/Arizona/Ba n ner+Good+Sa ma r i t a n+Med ica l+Center/P rog rams+a nd+Ser v ices/Suppor t+Ser v ices/Simulation+Education.htm

Laerdal site and NLN publications @ http://www.laerdal.com/document.asp?subnodeid=27282846

High-fi delity simulation in nursing education (2010) @ http://www.jbpub.com/catalog/9780763756512/

“Emerging Technologies in Nursing Education” Conference (2009) @ http://www.cforums.com/m413309/fac.asp

Incorporating scenario-based simulation into a hospital nursing education program (2009) @ http://www.jcenonline.com/view.asp?rID=35907

Simulation in nursing education: From conceptualization to evaluation (2007) @ http://www.nln.org/publications/Simulation/index.htm

Clinical Nursing Education Center for health professionals @ http://www.legacyhealth.org/body.cfm?id=1032

SPECIALIZED EDUCATION–American Association of Colleges of Nursing’s

“Cultural Competence in Baccalaureate Nursing Education” @ http://www.aacn.nche.edu/Education/pdf/competency.pdf

Health Resources and Services Administration (HRSA) (2008) numerous tools, standards, information about Cultural Competence Resources for Health Care Providers @ http://www.hrsa.gov/culturalcompetence/

City of Hope oncology @ http://www.cityofhope.org/educat ion/health-professional-educat ion/nursing-education/Pages/default.aspx

SOURCES OF DATA about nursing & nursing education–

Bureau of Labor Statistics 2008-2009 nursing labor outlook @ http://www.bls.gov/oco/ocos083.htm

Page 16 • DNA Reporter May, June, July 2009

Data Bits continued from page 15

NLN Nursing Education Research @ http://www.nln.org/research/index.htm

RESEARCH IN NURSING EDUCATION–National League for Nursing research priorities in

nursing education @ https://www.nln.org/research/priorities.htm

International Journal of Nursing Education Scholarship (2008) “Developing a self-concept of nurse in nursing students” @ http://www.bepress.com/ijnes/vol5/iss1/art5/

EVIDENCE-BASED REPORTS–search “nursing education” at the Cochrane Collaboration. Examine the evidence and determine how you can use the findings and conclusions in your practice setting, in client education sessions, in staff education, in formal nursing education programs, in community education, in publications, and/or at a personal level.

Risk assessment tools to prevent pressure ulcers (2008) @ http://www.cochrane.org/reviews/en/ab006471.html

Three 2008 systematic reviews about low back pain treatments (i.e., antidepressants, NSAIDs, intensive education @ http://www.cochrane.org/press/wiley/TCL.2008.Issue.1_lower_back_pain_cluster_FINAL.pdf

Continuing education meetings and workshops: Effects on professional practice and healthcare outcomes @ http://www.cochrane.org/reviews/en/ab003030.html

Nursing record systems: Effects on practice & outcomes @ http://www.cochrane.org/reviews/en/ab002099.html

School-based interventions to promote physical activity and fitness in children and adolescents aged 6-19 years (2009) @ http://www.cochrane.org/reviews/en/ab007651.html

Types of urinary catheters for short-term voiding problem management (2008) @ http://www.cochrane.org/reviews/en/ab004013.html

Anatole France

Jennifer L. Hargreaves earned her Bachelor of Arts from Catawba College in Salisbury, North Carolina where she majored in Psychology in 1993. She acquired a nursing diploma from Beebe School of Nursing in Lewes, Delaware in 2001.

Jennifer has been employed at Beebe Medical Center for over 12 years. Her nursing experience spans over Critical Care, Same Day Surgery, and Gastroenterology. Currently she is a clinical education specialist and coordinates the summer extern program and Internship at Beebe Medical Center. Jennifer is the current Nursing Advisory Council president as well as the vice president of the Beebe school of nursing alumni association. She sits on the Delaware Adolescence program incorporated board.

Jennifer can be reached at jhargreaves@bbmc.org or at her office which is (302) 645-3293

Barbara Moulinier earned her Master of Arts from the College of Notre Dame in Baltimore, Maryland where she majored in Human Resource Management and Health Care Administration.

During her career, Barbara has held several leadership positions including President of Reick and Associates which specialized in performance improvements; Vice President Quality and Support Services, director positions overseeing Medical Records, Patient Access, Quality Programs and Joint Commission.

In 1998, Barbara relocated to Rehoboth Beach and is currently responsible for Joint Commission and Process Redesign.

Barbara can be reached at bmoulini@bbmc.org or at her office which is (302) 645-3116.

In November 2003, The Centers for Medicaid and Medicare Services (CMS) and Joint Commission (JC) began working together on unified measures to improve patient safety called the National Patient Safety Goals (NPSG). In subsequent years, these agencies continued to enhance their requirements and standards of care, which can directly effect the level of reimbursement received. It can no longer be assumed that hospitals will be reimbursed for hospital acquired infections, bedsores, or other conditions and “never events” that can and should be prevented. With these national initiatives, educating team members became even more imperative to the safety of our patients and the financial stability of the organization.

In the past, our ongoing education was generally through members of the leadership team out among staff asking questions and inspecting for compliance.

“Nine Tenths of Education is Encouragement”The staff referred to these leaders as “suits”. This tactic resulted in staff hiding and becoming nervous or unable to think clearly to answer correctly.

Beebe Medical Center in Lewes, Delaware wanted to make the educational experience fun and rewarding while achieving success with the NPSG’s. One of the main initiatives, “Beebe Bucks”, came out of the Periodic Performance Review (PPR) team formed in 2007.

These coupons or “bucks” were created so staff could earn rewards for being informed. One buck was given for each correct answer. Five “bucks” could be redeemed for a small prize or snack coupon. Not only did the staff respond, they quickly realized they could answer five questions at a time and receive their prize or coupon that day.

Kickoff EventOne of the first PPR educational initiatives in 2007

was held in the winter months and was comprised of tables with displays for the NPSGs. Some examples of the education provided are:

• The Infection Control Practitioner and Lab staff collected thumb print samples and grew organisms from both clean and dirty hands to show how important proper hand hygiene is to prevent infections. The slides were very visual and made a lasting impression.

• The Patient Access Department and Lab staff worked together to illustrate the importance of accuracy and checking the two identifiers (name and date-of-birth) when comparing the patient to the requisition form. Some tricky examples were provided to prove the point of how easily mistakes can be made.

• The Risk Management Department had a display to help all staff understand the Falls Prevention policy and visual materials such as color-coded armbands used to easily identify patients at risk for falls.

• Nurses from the OR and Patient Care Units discussed each element of Universal Protocol and how important they are to patient safety.

Over 150 team members joined in the fun to learn about Joint Commission and Medicare initiatives to make our patients safer.

As the team became more experienced, other initiatives were held including special days when the PPR team disguised as Cash Cab look-alikes, would ride the elevators and walk the stairwells encouraging the team members to double their coupons by answering tougher questions. Over 300 questions were asked in a one-hour time frame with many team members taking the chance to double their winnings.

In an effort to reach out to our many satellite

Nine Tenths continued on page 17

May, June, July 2009 DNA Reporter • Page 17

Daaimah Aleem—Claymont

Grace Ampofoh—Dover

Karen Cannon—Milton

Caren Coffy—Newark

Ann Darwicki—Bear

Julianne DeRosa—Wilmington

Leslie Eisenbrey—Dover

Susan Felicia—Hockessin

Erlease Freeman-Goldsborough—Wilmington

Jean Gallagher—Wilmington

Beryl Gamiel—Wilmington

Jennifer Graber—Landenberg, PA

Kelley Lester-Garrett—Newark

Margaret Gatti—Ocean View

Darralyn Jannai Hall—Wilmington

Sylvia Judd—Camden

Nishelle Denise Harris-Hines—New Castle

Sharmila Johnson—Bear

Nora Katurakes—Wilma

Kathleen King—Newark

Moonyeen Klopfenstein—Wilmington

Mary Theresa Lednum—Bear

Susan Davies Lloyd—West Chester, PA

Fairuz Jazmin Lutz—Frederica

Frances Morthole—Seaford

Cheryl Nicholson—Middletown

LaTonya Mann—Penns Grove, NJ

Amanda Klockars-McMullen—Warwick, MD

Tracy Patrick-Panchelli—Exton, PA

Anya Bostian Peters—Hockessin

Jeanette Panunto—Dover

Bonnie Perratto—Dover

Melissa Raffaele—Harrington

Karen Ridley—Wilmington

Kristina Santoro—Newark

Lori Shifl ett—Wilmington

Michelle Sipple—Wilmington

Joan Thomas—Milton

Christina Trout—Lewes

Mary Torsch—Dover

Virginia Wagner—Bear

Yabo Yu—Newark

Continuing Education Committee NewsNancy D. Rubino, EdD, RNC and

Mary Lou Hamilton, MS, RNCo-chairs, DNA Continuing Education Committee

Continuing Education Committee AccreditationThe American Nurses Credentialing Center’s

Commission on Accreditation granted accreditation to the DNA CE committee as an approver unit for four

years from February 2009 through February 2013.

The Delaware Nurses Association is accredited as an approver of continuing nursing education by the American Nurses Credentialing Center’s

Commission on Accreditation.

ANCC Criteria ChangesThe following is a summary of changes to the

ANCC Accreditation Manual:Specifi c areas of change include (but are not

limited to):• The minimum amount of contact hours that may

be awarded for an educational activity is 0.5 contact hours (30 minutes).

• Provider units that targeted more than 50% of their educational activities provided in the previous calendar year to nurses in multiple regions (use the DHHS regions: http://www.hhs.gov/about/regions/), must apply to be accredited providers.

• Continuing Nursing Education units that targeted more than 50% of their activities provided in the previous calendar year to the nurses in a single state or region (or a state contiguous to that region) may apply to a Constituent Member Association for approval as providers.

• A fourth category of accredited approver was added—the national nursing organization based outside the United States. It may approve activities or providers within its constituency (within its country).

• Lead nurse planner responsibilities are clarifi ed.• Nurse planners must maintain expertise in

educational design and adult learning theories, receive orientation to, and maintain responsibility for implementing ANCC Accreditation Program criteria in their performance of the nurse planner role.

• Supporting evidence is clearly referred to as “required” evidence.

Welcome New

and Reinstated

Members!

• The rules for logo usage were revised.• A provider is ineligible for accreditation or

approval (approval of an activity or approval as a provider) if it is a commercial interest as defi ned in the “Standards for Commercial Support.”

• As previously, the nurse planner must have education or experience in the fi eld of education or adult learning. This revised manual provides further guidance on evaluating the “experience in the fi eld of education or adult learning” by stating that “The nurse planner must demonstrate competence in performing successfully at the expected level. Accepted demonstration of competence can be evaluated by review of the nurse planner’s professional portfolio.”

• Confl ict of interest must be disclosed relative to each activity. An original signature is not required. However, if an original signature is not used, the unit is advised to keep documentation supporting the source of the information.

• Enduring documents must include a statement that explains how long contact hour(s) will be awarded for an activity. This statement must appear on all marketing materials and on the title page of the educational materials.

• Criterion 3 now addresses unit operations.• Criterion 4 now addresses unit outcomes

evaluation.• The provider is tasked with identifying the

appropriate people to be involved in the evaluation of the provider unit.• Specifi c approved provider criteria have been

included in Appendix F.• Specifi c peer review/approval instructions for

the learner-directed activity are included.• A statement for the activity ‘pending approval’

is provided.• Specifi c monitoring requirements of the

accredited approver unit are identifi ed.• Defi nitions in the glossary were added and

revised.• Approved providers may co-provide activities.• Approved activities may be co-provided. The Commission on Accreditation may

decide to grant probationary status to a re-accreditation applicant.

All currently approved providers of continuing nursing education must implement the changes in 2009. Look for revised manuals and documents coming from the CE Committee.

locations, members of the PPR team ventured out with questions, candy, prizes, popcorn and peanuts to make sure every member of the Beebe family could participate.

With the great success of the “Beebe Bucks” the team then decided to take a quantum leap and hold a fun fair we called the “Backyard Bash” in July, 2008. This fair was held in our “backyard” and included various stations which represented a different National Patient Safety Goal and problem-prone standards within the Environment of Care and Emergency Management plans. We also reinforced our initiatives for the Core Measures. Dunking tanks, moon walk, duck pond, popcorn and peanuts were added to the fun fair theme.

These individual stations were designed to be quick and educational. On this day, ten Beebe Bucks could be cashed in for three balls to dunk the President, Chief Operating Offi cer, Vice Presidents of Patient Care and Medical Affairs, along with several directors and members of the Medical Executive Committee. Of course, for those of us who could not throw a ball, we were able to cash in our coupons for prizes.

The response and turn out was amazing. Over 200 team members from both clinical and non-clinical departments answered over 1200 questions. The questions were colored coded so that appropriate questions were available for each group and some questions could be answered by anyone. The most popular prize was of course the three balls for the dunk tanks. Our largest satellite location held a mini-Backyard Bash as well with dunk tanks, prizes, fun and games to ensure everyone had the same opportunity to participate in the learning experience.

The need is very real for every member of the Beebe staff, physicians and volunteers to support our culture of safety and have a thorough knowledge of the patient safety goals, core measures, and the environment of care.

The newest 2009 initiative by our PPR team is conducting mini-tracers. These tracers take approximately 15 minutes and provide us with valuable statistics on compliance. In addition, the data collected serves as the basis for the annual periodic performance review scores and allows us to continuously make improvements in our educational programs.

In the spring, we will be holding a Room of Horror fi lled with lots of errors to help staff visually identify problems related to some of the Joint Commission’s focused areas.

Through doing tracers and questioning staff after each special event, there has been a signifi cant improvement in retention and understanding of the patient safety initiatives. “Beebe Bucks” are still being distributed on the units by staff and managers. By using positive reinforcement team members were more apt to approach us for the questions rather then us hunting them down.

In an effort to be proactive, Beebe School of Nursing, in conjunction with the instructor’s Masters project, presented a conference, “Nurse as Teacher”, for the fi rst year students. Part of the thesis focused on the socialization of student nurses to the role as teacher through education of national organizations especially the ANA. The focus was the “teachable moment” and ways to take advantage of these moments in everyday care. As the senior students at our School of Nursing are rotating through clinical area, they are given the opportunity to work with us to assist with tracers, environment of care surveys, Emergency Management drills, and mini-tracers. Their participation will provide the PPR team with new ideas for new generations and help us design materials which are both educational and fun.

How did we know we were successful?It was during our recent Joint Commission survey

where the results of all of these efforts became obvious. When several of our team members very confi dently answered the Joint Commission surveyor’s questions correctly, and then said “don’t I get a Beebe Buck?” The surveyor laughed and complimented us on how comfortable our staff was during the entire survey and how well educated they were on the importance of the NPSGs, core measures, and other standards.

The success of the initiatives at Beebe Medical Center is due to the creativity and personal commitment of the PPR team members, the receptiveness of the entire Beebe family to be a learning organization, and the fi nancial support we have been given to continue our Beebe Bucks and prizes during a time when cost containment is so important. We truly appreciate all of the support to keep laughing, keep having fun, and to keep learning every day at the Medical Center.

Nine Tenths continued from page 16

Page 18 • DNA Reporter May, June, July 2009

Delaware Nurses Association/American Nurses AssociationMembership Application

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Return form to:Delaware Nurses AssociationOrchard Commons Complex

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Dual Membership Due$95.00 per year• RN holding membership in ANA through another state; proof of membership required

Methods of Payment❑ Full Annual Payment: Cash, Bank Card or Check made payable to the American Nurses Association❑ Electronic Withdrawal: Monthly electronic withdrawal from checking account (Authorization form on

ANA application—includes $6 service charge)

________________________________________________________________________________________________________ Visa/MC Number Expiration

AuthorizationThis is to authorize ANA to withdraw 1/12 of my annual dues from my checking account each month on or after the 15th day of each month, which is designated and maintained as shown by the enclosed check for the fi rst month’s payment. ANA is authorized to change the amount by giving the undersign thirty (30) days written notice. The undersign may cancel this authorization upon receipt by ANA of written notifi cation of termination twenty (20) days prior to deduction date as designated above.

_____________________________________________________________________________________________________ Signature for EDPP authorization

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