Paper
Saturday, July 14, 2007
Leading Change...Developing Bedside Leaders
Nena M. Bonuel, MSN, RN, CCRN, Center for Professional Excellence, The Methodist Hospital, Houston, TX, USA, Johnie Leonard, MSN, RN, Emergency Department, The Methodist Hospital, Houston, TX, USA, and Mary L. Shepherd, RN, MS, CNAA, Center for Professional Excellence NB1-087, The Methodist Hospital, Houston, TX, USA.
| Learning Objective #1: 1. Discuss the Nursing Clinical Career Progression Model. |
| Learning Objective #2: 2. Describe a structure mentoring program that positively impact the performance appraisal of staff nurses. |
While the healthcare environment races to keep up with professional and regulatory practice standards, the scope of the nursing profession broadens mandating a call for action to achieve superior patient outcomes. To rise above these challenges, an urban hospital implemented a professional practice model and curriculum that addressed performance improvement, evidence-based practice, professional development, resource management, communication and meeting management. A two day class including contact hours provided nurses the time, tools and resources to develop these new skills. One goal of this practice model was for staff nurses to develop an evidence-based performance improvement project within three months of attending class and present their findings to other staff nurses in a two day Magnet-Mentor Fair. Projects stemmed from opportunities identified by staff nurses through individual nursing unit Dashboard outcomes. The effectiveness of this educational strategy was evaluated by comparing annual RN performance appraisal ratings; unit-specific improvement in targeted patient outcomes is currently under review.Staff nurse responses to this program have been overwhelmingly positive. The transformation of these nurses to assume a leadership role in driving clinical quality and evidence-based practice was evident in the 2005 versus 2004 annual RN performance appraisal ratings, which statistically improved in several key criteria, e.g., on a six point scale with three meeting basic expectations and four being above average, clinical practice improvement and research improved from 3.56 to 3.96, image and communication improved from 4.43 to 4.50, nurse as teacher improved from 4.06 to 4.23 and patient safety improved from 4.55 to 4.63.
When nurses are fully supported in developing new skills to achieve competent practice congruent with the present demands, they become leaders at the bedside effecting positive change.