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The Clinical Nurse Leader

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The Clinical Nurse Leader Advancing Home and Hospice Care ... Diabetic Nurse Educator Two (2) CWOCNs Specialty staff function as Clinical Educators. – PowerPoint PPT presentation

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Title: The Clinical Nurse Leader


1
The Clinical Nurse Leader
  • Advancing Home and Hospice Care

Jennifer Beasley Collier, RN MSN CNL Director of
Education Alacare Home Health and Hospice, Inc.
2
Setting
  • Headquartered in Birmingham, Alabama
  • Provides skilled nursing, rehabilitative,
    palliative
  • and hospice services.
  • Provides services statewide, through 27
    branch
  • offices.

3
Interdisciplinary Team
  • Nurses
  • Home Care Aides
  • Physical, Occupation and Speech Therapists
  • Medical Social Workers
  • Nutritionists
  • Certified Diabetes Educator
  • CWOCN
  • Chaplains
  • Volunteer Coordinators

4
  • Home Care Average Daily Census
  • 5800
  • Hospice Average Daily Census
  • 590

5
Challenges in Setting
  • Coordination of Care
  • Identification of appropriate level of care
  • Disease State Management
  • Reducing re-hospitalizations
  • Reducing hospice revocations
  • Retention/Turnover

6
Challenges in Setting
  • Standardization of processes
  • Providing standardized, comprehensive orientation
  • Reimbursement issues

7
Job Role
  • Directs and coordinates overall departmental
    administration.
  • Two (2) Education Coordinators
  • One (1) Diabetic Nurse Educator
  • Two (2) CWOCNs
  • Specialty staff function as Clinical Educators.

8
Primary Job Functions
  • Directs and coordinates overall department
    administration.
  • Develops and monitors an orientation program for
    agency staff.
  • Directs specialty clinical services and
    coordinates the development of specialty programs
    to meet the specific needs of the agency.
  • Develops, implements and evaluates patient and
    family education materials for use in community
    and home

9
Secondary Job Functions
  • Facilitates special committees/projects that
    benefit the agency in terms of cost, quality and
    personnel.
  • Develops and participates in educational
    activities related to the medical community, area
    community and schools of nursing.
  • Other duties as assigned.

10
Impact of CNL
11
What I Learned and How I Grew.
  • Advocate
  • Identify clinical and cost outcomes that improve
    safety, effectiveness, timeliness, efficiency,
    quality and client-centered care.
  • Examples
  • Underpads, diapers
  • Formulary medications
  • Policy Committee
  • Palliative Care Program

12
What I Learned
  • Communicates effectively to achieve quality
    client outcomes.
  • Examples
  • Hospice Standing Guidelines
  • Protocol for Referral for CWOCN

13
What I Learned
  • Member of a Profession
  • Actively pursues new knowledge and skills as the
    CNL role, needs of clients, and healthcare system
    evolve.
  • Examples
  • Provided fourteen (14) external presentations
    during 2009 to community hospitals to increase
    awareness of current healthcare environment,
    common challenges and need for collaboration from
    setting to setting.

14
What I Learned
  • Team Manager
  • Properly delegates and utilizes the nursing team
    resources (human and fiscal) and serves as a
    leader and partner in the interdisciplinary
    health care team.
  • Examples
  • Redesign in the Hospice Interdisciplinary Group
    Meeting.
  • On-call readiness.
  • Discipline specific orientation and professional
    development programs.
  • Case Management Redesign.

15
Data Overload
  • POC System (HCHB)- approx 250 standard reports
  • ProClarity- customized reporting
  • FlexTrain
  • Home Health Compare
  • Press Gainey
  • Routine Audits
  • QI Audits

16
Data Overload
  • QAPI Audits
  • HospiScripts
  • Answering Service Reports
  • Fleet Management
  • Survey Monkey
  • Home Health QI Council
  • Hospice QI Council
  • Employee Viewpoint Surveys
  • Voice Committee

17
Data Overload
  • Exit interviews
  • Stay surveys
  • Retention reports/data

18
What I Learned
  • Information Manager
  • Uses information systems and technology at the
    POC to improve health care outcomes.

19
What I Learned
  • System Analyst/Risk Anticipator
  • Conduct a micro system analysis
  • Analysis of outcome
  • Analyze barriers and facilitators
  • Develop action plan
  • Present and disseminate to appropriate audiences.
  • Examples
  • Discontinuation of Hospice Comfort Kits
  • Medication Reconciliation
  • VIP Orientation

20
The Director of Education a Clinician?
  • Recognizing the influence of the meso and
    macrosystems on the microsystem.
  • Contribute to interdisciplinary plans of care
    based on best practice guidelines and evidence
    based practice.
  • Palliative Performance Scale
  • Braden Scale
  • Disease Management Programs

21
CNLs Greatest Contribution in Homecare/Hospice
Setting
  • Immunity from the day-to-day whirlwind.

22
CNL Educator
  • Uses appropriate teaching/learning principles, as
    well as materials and technologies.
  • Distant Learning Orientation utilizing
    multi-media.
  • CHEX
  • FLEX TRAIN- in house development
  • Live Meeting- Web Conferencing
  • Monthly CEU presentations via web-cast to meet
    agency specific needs.
  • In-house infomercials.

23
CNL as Educator
  • ELNEC Training (End of Life Nursing Education
    Consortium)
  • Annual in-service calendar
  • Ring of Knowledge
  • Hospice Boot Camp
  • Nursing Skills Fair
  • Quarterly Clinical Digest
  • Whats on Tap Monthly Newsletter
  • Monthly Customer Service Campaign

24
Jennifer Beasley, RN Director of Education Jennifer Beasley, RN MSN CNL Director of Education
Primary job focus- nursing orientation. Limited interaction with Branch Ops Participation in QI activity quarterly Limited committee participation Limited knowledge of care delivery processes. Generalist in the development and improvement of staff competency. Clinical Resource Collaborative relationships System Analysis and Resource Allocation Patient advocate Outcomes Manager Currently participates in 12 regularly scheduled committees.
25
Why apply for CNL certification if in
non-traditional role?
  • Defines specific set of competencies the CNL will
    bring to a non-traditional job role that will
    further advance bedside patient care.
  • Validates individual has completed all
    requirements for CNL certification.

26
Questions? Comments?
  • Contact Information
  • Jennifer Beasley Collier
  • Jennifer.beasley_at_alacare.com
  • 205-981-8759 Work
  • Alacare Home Health and Hospice
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