Tipton Health, the nation’s premier nursing consultancy, recently launched a new nursing excellence webinar to share some best practices and learnings on achieving ANCC Magnet® designation from its team
of nursing excellence experts. Tipton Health’s experts have successfully guided nursing teams to more than 300 Magnet® and ANCC Pathway to Excellence® designations.
Greg Tolliver, Tipton Health Assistant Director of Nursing Excellence Validation, hosted the “Writing for Successful Designation” roundtable. Panelists included Tipton Health Nursing Excellence Validation managers Jimmy Hicks and Katie Jacob; and Lindsey Owen, Assistant Director of the Nursing Excellence Validation Team.
Following are some of the questions asked by the audience of nurse leaders and responses from the Tipton Health nursing consulting team.
1. What Advice Would You Give to New MPDs Writing Their First Document?
Make sure you are collecting evidence that will substantiate your stories of excellence, Jacobs said. Too often a great example is lost because the evidence that the event actually took place was not saved. She cautioned that the evidence must “prove” the actions in the story actually occurred. “Follow the evidence, allow that to guide your story…[and] connect the dots,” she said.
Take meticulous notes and make sure meeting minutes and emails are saved, Hicks continued, as these provide evidence that the organization has met criteria. For example, “Document the nurses’ actions as much as possible to substantiate the story you’re telling,” he said.
Owen also stressed documentation. She explained that conversations must be documented, including the date and where they happened. Be familiar with the criteria in the manual and use the manual to map out your narratives.
As you’re writing your documents, go back to the criteria to be sure the example is complete. “Truly think through what is required for each example before beginning to write. You don’t want to start writing a story and realize you don’t have the evidence or the essential criteria you’re trying to write about,” she explained.
2. What are the Major Changes Between the 2019 and 2023 Magnet® Application Manual?
There were significant changes between the 2019 and 2023 Magnet® Application Manuals that significantly influence data collection. Hicks explained that most of those changes place a greater emphasis on evaluating nursing practice in the ambulatory care setting. There’s also a greater emphasis placed on documenting diversity, equity, and inclusion and demonstrating culturally and/or socially sensitive care.
The documentation must show specific actions that nurses have taken, demonstrating sensitivity to a patient or family’s social and/or cultural needs. For example, unique challenges may include social or cultural identities, practices, or restrictions not commonly seen in the organization.
One of the recurring problems in meeting this criterion is a lack of detail in a patient-specific story. Appraisers typically want information about how individual nurses were sensitive to individual patients’ needs, treated them without bias, made an effort to learn about their cultural or social differences, and incorporated that information into the plan of care. Hicks referred MPDs and writers to the Glossary in the Magnet® Application Manual to align the description of the nurses’ care with the definition of culturally and socially sensitive care.
3. What Are Some of the Most Common Reasons Applicants Receive a Deficiency or Additional Documentation Request?
The team offered detailed reasons organizations may receive a deficiency or request for additional documentation and highlighted some of the examples that most frequently receive deficiencies. In numerous cases, the reasons could be summed up as:
- Misalignment between dates in the narrative, evidence, and the graph.
- Missing key elements and supporting evidence, such as describing and naming a clinical nurse as a driving participant in the initiative.
- Missing key actions, such as CNO advocacy or ensuring leadership is involved in allocating resources.
- Missing ambulatory care examples.
Owen elaborated on the need to prove that something has happened. “How do I prove that this initiative being asked for happened? …We say to document everything, because just the notes that the clinical nurse was present during the meeting may be all the evidence you need,” she said.
4. Tipton Health has a nearly 100% Success Rate Helping Teams Achieve Magnet® and Pathway to Excellence® Designations. To What Do You Attribute Your Success?
Each of the presenters had a different reason they believe Tipton Health is so successful. Hicks stressed the meticulous process Tipton Health uses in reviewing the examples and documentation. Each example has more than one set of eyes on it to ensure that nothing is overlooked.
Jacob shared a little history, describing how the Tipton Health NEVT has worked together since 2008. She believes the team is fairly conservative in developing and coaching stories based on observed best practices. “So, there’s just a lot of knowledge and expertise that’s been developed over time. We review all the additional documentation requests our clients receive, which helps us identify best practices [in writing these documents]. We review these with our internal team, which helps us continually improve our practices and coaching,” said Jacob.
Finally, Owen believes the team’s depth and variety of experience gives them an advantage. “We have a unique perspective. We have nurses on our team and we also have people with extensive writing backgrounds. This enables us to find the story and the points of the story that tell it from start to finish, checking all the points of the criteria that need to be met,” she explained.
Tipton Health’s products and services are neither sponsored nor endorsed by the American Nurses Credentialing Center. ANCC Magnet Recognition, Magnet, The Magnet Prize, and Pathway to Excellence Program are registered trademarks of the American Nurses Credentialing Center.