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Tuesday, November 6, 2007

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This presentation is part of : Nursing Practice Initiatives
Intermediate Care Competency Orientation Program
Robyn Strauss, APRN, BC, MSN, CVN, WCC, Surgical Nursing, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
Learning Objective #1: identify the process for development of progressive care competency based education
Learning Objective #2: become familiar with strategies for implementation of a progressive care competency based education plan.

 Development of a 9 week evidence based progressive care competency program using  Clinical Nurse Specialist (CNS) role to integrate pathophysiology with clinical practice.  The competency program was developed primarily for new to practice nurses caring for complex vascular, plastic and thoracic surgical patients in a quaternary medical center using a universal bed model of care delivery. To address the unique clinical needs of vascular, plastic and thoracic surgical patients, competency topics included transcatheter therapy and post procedure care of the vascular and thoracic surgery patient, breast flap reconstruction, and respiratory adjuncts. 

 With each competency, a skills check list was developed delineating the step wise process required for safe clinical care. Patient care assignments were coordinated to coincide with the weekly didactic session offering validation through clinical observation of the peer preceptors and self evaluation during meetings with the unit based CNS.
 The educational curriculum included weekly meetings between the CNS and the orientee, discussion and review of didactic materials and completion of a post test to validate comprehension. 

 Transdisciplinary lectures and workshop sessions included nurse practitioners, surgical attendings and respiratory therapists. The participants observed surgical technique and pathologic examination relevant to weekly content topics.  This integrated experience combined with the didactic elements of the program fostered a unique learning environment for the nurse. The interdisciplinary collaboration forged partnerships and established long term sustainability while optimizing patient care and formed a foundation  for life long learning principles.

 Program benefits included timely completion of orientation materials, improved communication and standardization of care processes, and achievement of orientation goals. Future quantifiable measures will include improved staff satisfaction as measured by participation in the RN Satisfaction Survey in the National Database of Nursing Quality Indictors and institutional recruitment and retention reports.