Acute Medical Nursing Specialty Program AMNSP

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Acute Medical Nursing Specialty ProgramAMNSP

• Presented by
• Gerry Giesbrecht RN., MN
• Clinical Nurse Educator
• 2005
• Calgary Health Region

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Medical Inpatient Nursing Initiative

• Program Goals Pilot project May June 2001
• - To foster the specialty of Acute Medical
  Nursing
• To provide a foundation for the Recruitment and
  Retention of nursing staff
• Drivers
• Regionalization 3 adult sites / cultures
• Need for consistent standards across portfolio

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AMNSP Program Goals

• Provide specialty focused, in-depth preparation
  for acute medical nursing
• Facilitate confidence in practice abilities
• Facilitate critical thinking
• Promote excellence in patient care
• Enhance work life satisfaction
• Practice ready -gt job ready

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Target Population

• New graduates coming to the Calgary Health Region
• New graduates with undergraduate experience (UGE)
• Nurses from other countries
• Nurses with limited acute care experience
• Refresher nurses
• LPNs (since 2005)

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Program Model

• Initially
• Regional Extended Orientation twice/yr
• focused on skills (2 weeks)
• AMNSP Core Content - 10 -12 days
• Preceptored Clinical Experience - 10 days
• Today
• Regional Extended orientation (once/yr.)
• AMNSP core content monthly 5-6 days
• Guided shifts 7

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Description

• Class days (interactional) for content tailored
  to medical nursing
• Safety in nursing practice
• Urgent complex case scenarios
• Respiratory Patient Care
• Central Venous Catheter care
• Focus on critical thinking application
• Hands on for related skills
• Clinical guided shifts
• to develop skills/practice

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Recruitment Strategies

• Managers hiring
• Recruitment presentations
• Word of mouth
• Poster /brochure
• Educators

• Note of interest
• AMNSP influence on choosing Medical Nursing
  (2001)
• No 20
• Yes 12

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Funding Support

• Initial budget (2001)
• covered coordinator (not CNEs)
• New nurses salaries (94)
• Equipment supplies
• Tied in with Regional Extended Orientation grant
• Current budget (2005)
• - covers coordinator
• supplies only

• Today
• - Coordinator role changed
• - Nurses salary covered by
• hiring unit budget
• - equipment supplies taken from
• Medical Education Fund
• Support
• - Initially, managers bought in
• - grant money available
• - Now, managers
• - value program,
• - have confidence in it
• - like consistency across
• portfolio.
• - willing to pay

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Clinical Support Preceptors /Learning Guides

• preceptors chosen
• preceptors attended workshop
• AMNSP nurses
• assigned a preceptor
• Today focus on learning guides

• Challenge
• GN/Preceptors ratio
• Aim for 11
• Some had 17
• Learning guides need coaching for intentional
  guiding

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Evaluation Tools

• Multiple strategies used in past 4 years
• Daily Evaluation
• Reflective Journaling ( 3 occasions)
• Group Case Studies - pre and post
• Course Evaluation
• Orientation Checklist (Preceptor feedback)
• Preceptor and Orientee Reflection
• Retention Statistics
• Manager / Instructor Evaluation

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Outcomes

• New grads - feel supported and valued
• Confidence increased from low / stressed
• to a good level / tentative due to clinical
  reality
• Quotes
• The CHR wants me to have the best practice
  possible
• AMNSP made the CHR a desirable place to work.
• Retention
• after first 2.5 y, 73 retention
• Today ____ retention

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Feedback Preceptors/managers

• Clear, consistent program objectives teaching
• Aim to follow preceptors rotation - consistency
• Liked workshop for preceptors
• Makes me feel good to share knowledge
• Excellent learning opportunity, ..felt valued

• Need more clinical days and skills experience
• Difficulty scheduling with guides schedule
• Workload determined the quality of coaching
• Those moving from UNE role to GN - needs varied
  from other new staff

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Sustainability

• Higher standard set valued
• Positive effect on other regional educational
  initiatives
• Support has been established
• from administration/managers
• Financial support stable
• major cost is imbedded in unit budgets.
• equipment cost is minor
• Resources pooled
• Educators share the workload
• Program evolved shorter, more focused

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Key Learnings

• Program
• need this bridge for Best practice
• supports recruitment retention
• supports consistent standard
• Educator team
• raised awareness of educational needs
• consistency in educational focus
• better use of our time / resources
• Learners
• high need for support during this transition
• able to identify strengths gaps early,
• able to access CNE support early