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Virtual Reality: The Student Perspective on the Clinical Nurse Leader

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Tamela Garcia, RN, MSN. Nancy Adams, RN, MSN. Questions? ... Graduated with MSN from University of South Florida in the first CNL program in May of 2006. ... – PowerPoint PPT presentation

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Title: Virtual Reality: The Student Perspective on the Clinical Nurse Leader


1
Virtual Reality The Student Perspective on the
Clinical Nurse Leader
  • CNL Network Teleconference
  • July 19, 2006
  • Tamela Garcia, RN, MSN
  • Nancy Adams, RN, MSN

2
Questions?
  • Please email any questions to Joan Stanley at
    jstanley_at_aacn.nche.edu before, during, or after
    the presentation. Thank you!

3
Speaker Introduction
  • Nancy Adams
  • Graduated with MSN from University of South
    Florida in the first CNL program in May of 2006.
    Employed at Morton Plant Mease Clearwater
    Hospital, FL. She has been an oncology nurse on
    an oncology unit with medical/surgical overflow
    for 19 years.
  • Tamela Garcia
  • Graduated with MSN from University of South
    Florida in the first CNL program in May of 2006.
    Employed at Morton Plant Mease Countryside
    Hospital, Safety Harbor, FL. She has been a
    telemetry nurse for 5 years and works on a
    medical/surgical remote telemetry unit.

4
The USF CNL Program
  • 33 credit hours
  • 300 hours of clinical residency
  • CNL seminar each semester to prepare us for the
    role
  • For more information http//hsc.usf.edu/nocms/nur
    sing/Programs_of_Study/cnl.html

5
Why our CNL Program/Seminars are Successful
  • Strong quality and safety culture
  • Dynamic Clinical Nurse EducatorSue Hartranft
  • Supportive organization and management
  • Seminars designed/taught by a leader from each
    practice partnership
  • Utilized the same clinical objectives/outcome
    indicators for all practice partners

6
Why our CNL Program/Seminars are Successful
  • The CNL preceptor was the same person who
    designed/taught the seminars
  • A Morton Plant Mease (MPM) Foundation grant
    supported a work-study program that paid the MPM
    students a full time salary while they were in
    school
  • Full-time versus part-time residency
  • Residency was on the unit that the CNL was hired
    on after graduation

7
The CNL Role Today
  • Twelve/Fifteen patients
  • 24 Hour Accountability
  • Monday-Friday 0800-1630 workday
  • Work with two RNS/PCTS with six/seven patients
    each

8
A Day in the Life of a CNL
  • Greet staff
  • Obtain staff assignment and patient information
  • Obtain patient report/plan of care from staff
    nurses
  • Meet with Social worker for planned discharges
  • Review all labs/radiology reports (address
    abnormals)
  • Review telemetry strips
  • Round on all patients
  • Round with MDs
  • Complete all indicators and chart reviews

9
The CNL Role Continues
  • Major resource for the nurses
  • Design plan of care for the patient with
    collaboration from MD/Nurse/Patient and other
    interdisciplinary services
  • Cover staff as needed (meds, ADLs, cover pts for
    breaks)

10
Indicators/Outcomes
  • Discharge by 1100 or within one hour of written
    discharge if patient is going home
  • Discharge planning begins at time of admission
  • RN/Patient goals for the day is discussed and
    written on the whiteboard
  • Patient satisfaction with pain management
  • All patient education is completed
  • Fall assessment/prevention
  • Skin assessment/prevention

11
Indicators/Outcomes
  • Other areas we look at are
  • Central line dressing changes
  • Medication reconciliation forms
  • Advanced Directives
  • Discharge patient survey
  • Increased nursing satisfaction

12
Barriers of New Role
  • Uniform
  • In order for us and others to view us in our new
    role we wore lab coats, student badge, and
    professional street clothes
  • Experience nurses felt threatened
  • Was able to gain their acceptance by
    communicating and demonstrating leadership in the
    role
  • Non core staff
  • Working with travelers and float nurses to
    elicit team spirit and providing quality care

13
Successes
  • Found diabetic supply resource for a patient
  • Prevented alcoholic patient from leaving without
    proper discharge instructions
  • Assessed/evaluated care of patients which
    identified educational opportunity due to unsafe
    nursing practices
  • Moved terminally ill patient to lower level of
    care and honored patient and family wishes

14
Successes
  • Identified patient no longer receiving HHC
    supplies and was able to provide supplies from
    new HHC agency
  • Reroute readmissions of oncology patients to CNL
    unit for continued continuity of care
  • Call received from spouse after patient died to
    commend CNL on care provided
  • Discussions with patients/families on various
    religious and end of life issues

15
Future Plans/Ideas
  • Implement EBP to bedside
  • Post-discharge phone calls
  • Develop patient educational tools and standards
  • Precept new CNLs
  • Continually be JCAHO compliant and Magnet
    accredited
  • Actively involved in professional organizations
  • Quantified data/research

16
The END
  • Questions? Please email them to Joan Stanley at
    jstanley_at_aacn.nche.edu
  • Thank you!
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