Happy Nurses Month and Congratulations to Recent Magnet® Designees

As your partner throughout your Magnet^® Designation journey, we extend to you a heartfelt Happy National Nurses Month in recognition of all the amazing things you have accomplished and your ongoing commitment to your nursing teams.

(View Nurses Month messages from the dedicated nursing excellence consultants on the Tipton Health team.)

Now it’s time for us to express our joy and congratulations for our Nursing Partners who have successfully received Magnet^® Designation in the last few months. Here is a partial list of designees with whom we were fortunate to work!

• Geisinger Wyoming Valley Medical Center
• Hackensack Meridian JFK University Medical Center
• Henry Ford West Bloomfield Hospital
• Johns Hopkins All Children’s Hospital
• Ochsner Medical Center – New Orleans
• Valley Children’s Healthcare
• Virtua Vorhees Hospital
• West Kendall Baptist Hospital

We are so proud of these partners and their achievements that make a world of difference for patients and nurses each day! We hope each of your nurses enjoys a wonderful and well-deserved month of recognition! Let’s spread it throughout the year together!

The Commission on Magnet^® and the American Nurses Association (ANA) Enterprise Institute for Nursing Research and Quality Management announced in March that it will conduct a comprehensive review of the Magnet^® Model with the intention of modernizing Magnet^® requirements. The review aims to update the standards and model to accommodate global cultures and nursing practices, align with the latest evidence-based practices, and include additional factors related to patient care and nursing practice environments.

Patricia A. Patrician, PhD, RN, FAAN, professor; Rachel Z. Booth, endowed chair in Nursing, University of Alabama at Brimingham, and co-director, VA Quality Scholars Fellowship Program; and Sean Clarke, PhD RN, FAAN, Ursula Springer professor in Nursing Leadership and executive vice dean, Rory Meyers College of Nursing, New York University, and editor-in-chief, Nursing Outlook, have been selected to lead the review.

Towards Magnet^® 3.0: A Systematic Literature Review and Mixed Methods Study will focus on five themes: patient outcomes, work environment, nurse engagement, quality, and current environment. The ANA lists the following project aims:

• “Conduct a comprehensive literature review of Magnet^® hospitals over the past two decades, specifically focusing on the Magnet^® Model components.”
• “Identify organizational and nursing factors influencing work environment, nurse engagement, retention, and their impact on patient outcomes and value.”
• “Recognize and assess factors like nurse wellness, [diversity, equity, inclusion, and justice] DEIJ, justice, and the dynamic healthcare landscape in connection with the Magnet^® Model components.”
• “Validate findings through electronic surveys and individual interviews with key stakeholders in Magnet^® and Magnet^®-Aspiring hospitals” (ANA, 2024).

Tipton Health is excited to learn more about the findings of this study and the recommendations of the review team. We stand ready to support our partners as Magnet^® 3.0 takes shape and comes to bear on nursing practice and Magnet^® Designation.

References:

ANA Enterprise. (2024, March 8). ANA Enterprise Institute for Nursing Research and Quality Management Launches Magnet Model Review. ANA Enterprise. Retrieved from ANA Enterprise Institute for Nursing Research and Quality Management Launches Magnet Model Review (nursingworld.org)

Ambulatory care is a rapidly growing field, and the ANCC places significant emphasis on ambulatory care setting for certain Magnet^® Designation examples. Our experience with Magnet^® and working with our nursing partners has given us insights into some of the more challenging ambulatory care setting examples that we would like to provide guidance on to help make these examples go as smoothly as possible. Let’s start with the new EP6 example.

EP6 – Interprofessional Care

In the EP6 examples, we look at how nurses use the available resources to coordinate care for patients to and from ambulatory units. We have noticed that the most challenging of these is EP6c, which requires an ambulatory-to-ambulatory transition. The most important thing about the EP6c example that separates it from the EP6a and EP6b examples is that the patient cannot be admitted to an inpatient setting at any point in the narrative, even if the patient moves through multiple ambulatory settings after the inpatient admission. If the example involves an inpatient admission, it will not meet intent for EP6c.

Some of the strongest EP6c examples we have seen involve patients who arrive to an ambulatory clinic, at which point there are complications that the current ambulatory clinic is unable to address due to the patient needing a different skill set than the interprofessional care team has at the first ambulatory location, a different care environment, or technology to receive the best care. In these examples, the patient is then referred to and arrives at a second ambulatory care setting that can provide for that patient’s needs. The strongest evidence for EP6 examples will demonstrate nurse actions to request consults with the interdisciplinary team members, as well as nurse actions related to family care meetings, rounding, and patient discharge. We are always looking to prove and recognize what your nurses did to ensure the patient received the exceptional care they needed and deserved.

SE13 – Commitment to Community Involvement

Both SE13 examples require evidence of a nurse, or group of nurses, delivering culturally/socially sensitive care, but SE13b requires this in an ambulatory care setting. Because many ambulatory visits are brief, it is sometimes challenging to find examples of robust sensitive care to meet this requirement. We have identified some similarities between successful ambulatory examples, however.

Implementing translation services in an ambulatory care setting for non-English speaking patient populations based on nurses’ efforts to provide culturally appropriate and sensitive care is a great option, and this can be done with cooperation with Human Resources or Technology services. Other strong examples have involved changing some aspect of the nursing practice environment for specific patient populations, such as acquiring and implementing special operating tables for bariatric patients or implementing transportation services for patients who have difficulty reaching the ambulatory location. Strong evidence for these examples includes documentation to demonstrate the patient’s culturally/socially sensitive need and proof of the nurse actions to address those needs. In some cases, this may include the patient’s nurse(s) reaching out across departments to help coordinate the care.

SE10EO – Teaching and Role Development

The SE10EOb example requires an improved patient outcome related to a nursing needs assessment and associated implementation plan in an ambulatory care setting. The nursing needs assessment does not have to be in a traditional needs assessment format (i.e. a traditional needs assessment survey), but it will need to pinpoint a level of educational need and result in purposeful education to close the gap. The needs assessment must allow nurses to self-report their educational needs or comfort level with specific processes. For example, a unit-level nursing survey measuring the “comfort level” nurses have with certain technologies or concepts could work, as long as the identified educational need results in purposeful education that increases the ambulatory nurses’ skills or comfort levels with concepts relating to patient outcomes.

We have found that strong outcome measures for this ambulatory example include fall rates, average length of stay (ALOS), and readmission rates. Readmission rates and ALOS are strong outcome measures for a needs assessment due to their compatibility with improvements in knowledge. For example, a needs assessment could point out a need for education related to the use of a newly adopted technology. It is then discovered that the lack of knowledge related to the technology is increasing ALOS for patients. The implementation of the education plan to address the need leads to less time spent on using the technology, thereby reducing ALOS. The evidence files needed for these examples are a copy of the needs assessment and the related implementation plan. The evidence should include all the questions the nurses responded to, as well as a roll-up summary of their responses. The narrative will do the work to explain how the needs assessment connects to the education implementation plan.

Aimee serves a double role on the Tipton Health team as a data analyst on the Data Services Team and an editor on the Nursing Excellence Validation Team (NEVT). Ever willing to help our nursing partners, she works where her variety of skills are needed most. She is a regular contributor to our Magnet^® Connections newsletter for all things data related and is eager to offer her advice. We spoke with Aimee about her roles and recommendations for Magnet^® Program directors at all stages of their Magnet^® Designation journeys.

How would you describe your experience working on the data team and with the NEVT?

I feel incredibly fortunate to have a dual role at Tipton Health! Working closely with both the Data Services team and the NEVT has truly enriched my experience. It offers me a unique vantage point where I get to delve into both the narratives and the data supporting them. It’s incredibly fulfilling to immerse myself in the stories and comprehend the intricacies of the data behind them.

Is there anything that you wish our nursing partners knew at the beginning of their Magnet^® Designation journeys?

One thing I’d like our nursing partners to know as they embark on their Magnet^® Designation journeys is the importance of not procrastinating on the Fab 5 until the last minute. It’s understandable. Data can feel overwhelming or even intimidating, but the Data Services team is here to provide support every step of the way. From analyzing your data to showcasing your organization’s best performance, we’re dedicated to making this journey as stress-free as possible. We’ll work collaboratively with you, evaluating different categories, questions, benchmarks, and more to ensure your organization shines brightly throughout the process.

Speaking of advice, is there anything you can tell us about the Fab 5 that will make it easier for our partners?

Absolutely! One crucial tip I can offer is to start working on your Demographic Data Collection Tool^® (DDCT) sooner rather than later. Gathering all the necessary information for it can be quite time-consuming. By initiating the process early on, you’ll alleviate a lot of stress down the line and ensure a smoother experience.

What would you say are the most rewarding parts of working at Tipton Health?

The most rewarding aspect of my roles on both the data team and NEVT is undoubtedly the opportunity to make a meaningful impact. In my position on the data team, it’s immensely gratifying to see our partners’ progress and success, especially when overcoming data-related challenges. Being able to support them in showcasing their organization’s strengths is truly fulfilling. Similarly, within the NEVT, seeing these narratives come to life and positively influence decision-making processes is incredibly rewarding. I believe that the common thread is the sense of partnership and the opportunity to contribute to our partners’ success. That, to me, is the most rewarding part of my job.

Can you tell us anything that will make it easier for our partners as they approach the close of their Magnet^® writing windows and get ready for submission?

I want to emphasize that we’re here to support you every step of the way. Please don’t hesitate to reach out with any questions or concerns you may have. Your success is our priority, and we’re dedicated to helping you reach the finish line with confidence.

We are back this month to bring you the latest scoop on how your organization can navigate the intricacies of pulse surveys, as outlined by the American Nurses Credentialing Center (ANCC). RN satisfaction pulse surveys are becoming increasingly popular in gauging employee satisfaction and engagement, and understanding how to leverage them effectively can make all the difference in fostering a thriving workplace environment.

What Are Pulse Surveys?

Pulse surveys are concise, targeted assessments designed to capture real-time feedback from employees on various aspects of their work environment. Unlike traditional, comprehensive surveys, pulse surveys are quick, often consisting of just a few questions, making them a convenient tool for collecting data efficiently. What sets pulse surveys apart is their ability to focus on select units within your organization, whereas full surveys typically affect all units and categories. This targeted approach allows for a more nuanced understanding of specific areas for improvement, without overwhelming the entire workforce with extensive questionnaires.

ANCC’s Guidelines for Pulse Surveys

The ANCC has established guidelines for organizations looking to utilize pulse surveys effectively, especially in the context of assessing nurse satisfaction and engagement. Here’s a breakdown of what you need to know:

Supplementing Full Surveys: If your organization did not outperform in the original full RN Satisfaction/RN Engagement Survey, you have the opportunity to submit results from a nationally benchmarked vendor pulse survey to demonstrate overall outperformance. This offers a chance for your organization to showcase improvements and initiatives aimed at enhancing employee satisfaction and engagement. If you’re considering this option, be sure to talk with your vendor to see if they provide pulse surveys.

Targeted Approach: One great way to make the most of RN pulse surveys is to focus on the units that didn’t shine in the original full survey. This targeted strategy lets your organization zero in on areas for improvement without risking the stellar scores of your top-performing units from the full survey. It’s a win-win situation that ensures you’re tackling challenges head-on while maintaining the momentum of your successes.

Timing and Alignment: The RN pulse survey must be administered after the original full survey, ensuring that the data collected is up-to-date and reflective of current sentiments. Additionally, the most recent full survey must align with the same four Magnet^® categories used in the pulse survey, maintaining consistency and comparability in the evaluation process. If you do more than one pulse survey, you can only submit the results of the most recent survey. If your organization is outperforming on one pulse survey, you should not do another one.

Participation Rate: It’s crucial to provide the participation rate for the RN pulse survey, offering transparency and insights into the level of engagement among employees. Your organization should aim for a high participation rate.

Scoring Threshold: To advance to the site visit phase, the RN satisfaction/RN engagement data must meet the scoring threshold for excellence in the Written Documentation phase. This underscores the importance of not only collecting data but also implementing strategies to drive meaningful improvements in employee satisfaction and engagement. It’s worth noting that this scoring threshold applies to the combined view of both the full survey and any units that were pulsed. This holistic approach ensures that organizations focus not just on individual snapshots of data but on overarching trends and outcomes that contribute to a culture of nursing excellence.

Unlocking Success

By adhering to ANCC’s guidelines for RN pulse surveys, your organization can unlock a pathway to success in enhancing nurse satisfaction and engagement. These surveys serve as valuable tools for gathering feedback, identifying areas for growth, and ultimately fostering a workplace culture where nurses feel valued and empowered.

The Tipton Health Assessment was developed to help our nursing partners to celebrate their nursing excellence triumphs and prioritize their outstanding challenges. The assessment is complimentary to all Tipton Health partners, because it aligns our work with our client’s needs and prepares our partners for a successful nursing excellence journey.

How The Assessment Works

• Our partners provide information and data related to the evidence-based nursing excellence structures that most impact nursing leadership, the work environment, the advancement of the profession, and ultimately patient outcomes.
• We deliver a comprehensive analysis that includes a projected timeline to achieve nursing excellence milestones, such as ANCC Magnet^® Designation or Pathway to Excellence^® Program Designation. We prioritize nursing excellence structures and evidence-based solutions that will have the most impact.

We deliver the priorities aligned with the organizations strategic priorities, return on investment, and nursing excellence frameworks. The alignment supports nurse leaders in their advocacy and communication of the value nursing excellence brings to an organization at all levels.

In addition to sharing our findings with nurse leaders, we also engage key stakeholders, such as the C-suite as a way to support the advancement of and investment in nurses.

CNOs and their teams have expressed tremendous gratitude and recognized the level of expertise, attention to detail and investment in time that Tipton Health commits to this complimentary process. The impact in some cases has resulted in organization’s full investment in a multiyear plan to support nursing excellence as well as providing organizations a road map for their nursing strategic plan and journey of nursing excellence. Most importantly, we have established meaningful relationships with nursing partners through this process. The process alone serves as an intervention that enables us to let nursing teams know that they are not alone in their challenges as we help forge a path forward.

We invite any of our partners to participate in this complimentary program. Whether you are considering designation for the first time, a redesignation, or you just want to know where you stand and what step to take next, we are happy to partner with you for this complimentary service.

We are proud at Tipton Health to support nursing excellence for hundreds of thousands of nurses. Our work is guided and inspired by the many nurses who work at Tipton Health. Following are some of the messages our nurses wanted to share with the nursing community.