Bockowski Complete CNL Clinical Hours Spring 2014

AACN CNL End-of-Program Competencies Required Clinical Experiences Graduate Level CNL Role CNL Role End of Curriculum
Functions Expectations Program Elements Competencies Keeps clients well Effects change Nursing Leadership Advocate informed through advocacy for the profession, interdisciplinary health care team and the client. Required Clinical Experiences Identify clinical and cost outcomes that improve safety, effectiveness, timeliness, efficiency, quality and clientcentered care.
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AACN CNL End-of-Program Competencies Required Clinical Experiences Graduate Level Curriculum Elements CNL Role Functions End of Program Competencies Includes clients in Communicates care planning effectively to achieve quality client outcomes and lateral integration of care for a cohort of clients. CNL Role Expectations Required Clinical Experiences Communicate within a conflict milieu with nurses and other health care professionals who provide care to the same clients in that setting and in other settings.
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Advocates for the profession
Review and evaluate patient care guidelines/protocols and implement a guideline to address an identified patient care issue like pain management or readiness for discharge; follow-up to evaluate the impact on the issue.
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AACN CNL End-of-Program Competencies Required Clinical Experiences Graduate Level Curriculum Elements CNL Role Functions CNL Role Expectations Works with interdisciplinary team End of Program Competencies Required Clinical Experiences Discover, disseminate and apply evidence for practice and for changing practice.
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AACN CNL End-of-Program Competencies Required Clinical Experiences Graduate Level Curriculum Elements CNL Role Functions CNL Role Expectations Strives to achieve social justice within the microsystem End of Program Competencies Required Clinical Experiences Participate in development of or change in policy within the health care organization.
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Identify potential equity and justice issues within the health care setting related to client care. Present to appointed/elected officials regarding a health care issue with a proposal for change. Analyze the care of a patient cohort and the care environment in light of ANA Nursing Standards of Care and the Code of Ethics.
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AACN CNL End-of-Program Competencies Required Clinical Experiences Graduate Level Curriculum Elements CNL Role Functions CNL Role Expectations End of Program Competencies Required Clinical Experiences Analyze interdisciplinary patterns of communication and chain of command both internal and external to the unit that impact care.
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Nursing Leadership Member of a Effects change in Actively pursues Develop a life long Profession health care practice new knowledge learning plan for self. and skills as the CNL role, needs of clients, and the health care system evolve.
Effects change in health outcomes
Speak at a public engagement to a public forum.
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AACN CNL End-of-Program Competencies Required Clinical Experiences Graduate Level Curriculum Elements CNL Role Functions CNL Role Expectations Effects change in the profession End of Program Competencies Required Clinical Experiences Participate in a professional organization/or agency wide committee.
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Care Environment Management
Team Manager
Properly delegates Properly and manages delegates and utilizes the nursing team resources (human and fiscal) and serves as a leader and partner in the interdisciplinary Uses team health care resources team. effectively
Design, coordinate, & evaluate plans of care for a cohort of patients incorporating patient/family input and team member input.
Monitor/delegate care in the patient care setting.
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AACN CNL End-of-Program Competencies Required Clinical Experiences Graduate Level Curriculum Elements CNL Role Functions CNL Role Expectations Serves as leader/partner on interdisciplinary team End of Program Competencies Identifies clinical and cost outcomes that improve safety, effectiveness, timeliness, efficiency, quality, and the degree to which they are clientcentered. Required Clinical Experiences Present to the multidisciplinary team a cost saving idea that improves patient care outcomes and improves efficiency
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Conduct a multidisciplinary team meeting; incorporate client and/or family as part of the team meeting
Care Environment Management
Information Manager
Uses information systems / technologies
Uses information systems and technology at the point of care to improve health care outcomes
Using patient information system data, design and implement a plan of care for a cohort of patients.
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AACN CNL End-of-Program Competencies Required Clinical Experiences Graduate Level Curriculum Elements CNL Role Functions CNL Role Expectations Improves health care outcomes End of Program Competencies Required Clinical Experiences Use aggregate data sets to prepare reports and justify needs for select care improvements.
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AACN CNL End-of-Program Competencies Required Clinical Experiences Graduate Level Curriculum Elements CNL Role Functions CNL Role Expectations End of Program Competencies Required Clinical Experiences Evaluate the impact of new technologies on nursing staff, patients and families.
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AACN CNL End-of-Program Competencies Required Clinical Experiences Graduate Level Curriculum Elements Care Environment Management CNL Role Functions CNL Role Expectations End of Program Competencies Participates in systems review to critically evaluate and anticipate risks to client safety to improve quality of client care delivery. Required Clinical Experiences Participate in establishing and reviewing interdisciplinary patient care plans with team.
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Systems Participates in Analyst / Risk system reviews Anticipator
Evaluates / anticipates client risks to improve patient
Apply evidence-based practice as basis for client care decisions
Conduct a microsystem analysis by: Identifying a clinical Conducting a trend analysis of incident reports Evaluating a sentinel event and conducting a root cause analysis (RCA) Incorporating analysis of outcome data Analyzing barriers and facilitators within the organization related to the identified issue Writing an action plan related to the analysis \\vboxsrv\conversion_tmp\scratch_5\220676152.xlsx.ms_office 10 of 44
AACN CNL End-of-Program Competencies Required Clinical Experiences Graduate Level Curriculum Elements CNL Role Functions CNL Role Expectations End of Program Competencies Required Clinical Experiences Presenting/disseminat ing to appropriate audience.
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AACN CNL End-of-Program Competencies Required Clinical Experiences Graduate Level Curriculum Elements CNL Role Functions CNL Role Expectations End of Program Competencies Required Clinical Experiences Work with quality improvement team and engage in designing and implementing a process for improving patient safety.
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AACN CNL End-of-Program Competencies Required Clinical Experiences Graduate Level Curriculum Elements Clinical Outcomes Management CNL Role Functions Clinician CNL Role Expectations Designs/ coordinates/ evaluates care End of Program Competencies Assumes accountability for healthcare outcomes for a specific group of clients within a unit or setting recognizing the influence of the meso- and macrosystems on the microsystem. Required Clinical Experiences Plan and delegate care for clients with multiple chronic health problems, identify nursing interventions to impact outcomes of care.
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AACN CNL End-of-Program Competencies Required Clinical Experiences Graduate Level Curriculum Elements CNL Role Functions CNL Role Expectations Delivers care in a timely, cost effective manner End of Program Competencies Required Clinical Experiences Using an existing database, evaluate aggregate care outcomes for a designated microsystem with focus on specific nursing interventions
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AACN CNL End-of-Program Competencies Required Clinical Experiences Graduate Level Curriculum Elements CNL Role Functions End of Program Competencies Emphasizes health Assimilates and promotion/risk applies researchreduction based information to design, implement and evaluate client plans of care. CNL Role Expectations Required Clinical Experiences Contribute to interdisciplary plans of care based on best practice guidelines and evidence-based practice.
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Clinical Outcomes Management
Outcomes Manager
Uses data to Synthesizes change practice and data, improve outcomes. information and knowledge to evaluate and achieve optimal client and care environment outcomes.
Coordinate care for a group of patients based on desired outcomes consistent with evidence-based guidelines and quality care standards.
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AACN CNL End-of-Program Competencies Required Clinical Experiences Graduate Level Curriculum Elements CNL Role Functions CNL Role Expectations Achieves optimal client outcomes End of Program Competencies Required Clinical Experiences Revise patient care based on analysis of outcomes and evidence-based knowledge.
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AACN CNL End-of-Program Competencies Required Clinical Experiences Graduate Level Curriculum Elements CNL Role Functions CNL Role Expectations End of Program Competencies Required Clinical Experiences
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Analyze unit resources and set priorities for maximizing outcomes Conduct a patient care team research review seminar
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AACN CNL End-of-Program Competencies Required Clinical Experiences Graduate Level Curriculum Elements Clinical Outcomes Management CNL Role Functions Educator End of Program Competencies Uses teaching/ Uses appropriate learning principles/ teaching/learnin strategies g principles and strategies as well as current information, materials and technologies to facilitate the learning of clients, groups and other health care professionals. CNL Role Expectations Required Clinical Experiences Present a seminar or case study at a grand rounds or team meeting.
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Uses current information/ materials/ techniques
Conduct health education of individual patient or cohort based on risk profile.
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AACN CNL End-of-Program Competencies Required Clinical Experiences Graduate Level Curriculum Elements CNL Role Functions CNL Role Expectations Facilitates clients learning, anticipating their health trajectory needs. End of Program Competencies Required Clinical Experiences Create or review an education module directed at patients and staff; develop a self-management guide for patients and families.
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AACN CNL End-of-Program Competencies Required Clinical Experiences Graduate Level Curriculum Elements CNL Role Functions CNL Role Expectations Facilitates client care using evidencebased resources. End of Program Competencies Required Clinical Experiences Develop and implement a professional development session for other professional nursing and ancillary staff.
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AACN CNL End-of-Program Competencies Required Clinical Experiences Graduate Level Curriculum Elements CNL Role Functions CNL Role Expectations Facilitates group & other health professions learning and professional development End of Program Competencies Required Clinical Experiences Develop a health education plan for a unit-specific issue common to multiple clients.
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AACN CNL End-of-Program Competencies Required Clinical Experiences Graduate Level Curriculum Elements CNL Role Functions CNL Role Expectations End of Program Competencies Required Clinical Experiences Implement & evaluate the health education plan, evaluating the role of the team, the teaching learning methods used, the client interactions, the expected & actual outcomes, including health status changes.
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AACN CNL End-of-Program Competencies Required Clinical Experiences Date & Examples of Experiences Completed Hrs 6777 Hrs Quality 6775 Res Hrs 6776 Adv Ed Hrs 6773 Resid
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June 14, 2013. Assessed discharge needs for a Neuro ICU patient with a new DX of ALS. Collaborated with other members of the team to arrange for ordered medication, portable vent set up at home, transportation, and nutritional needs. October 4, 2013. Gathered information from patient record to complete a QI tool sheets for patients postFontan procedure February 3, 2014. Attended a meeting to discuss several ideas in order to improve quality of care and patient satisfaction. Topic covered include (creating bath schedules, volunteers sit with patients who are lonely). February 21, 2014 Partcipated in the revision of peerreview forms for the mid-year evaluations. With the goal to gather information from nurses and their peers about the proiority concepts related to enhanced patient care. March 03, 2014. Attended a meeting associated to verbal order with the ED physicians, and senior management of the hospital, to discuss admitting order process and hand off between ED physicians and hospitalists. March 19, 2014 Managers meeting to discuss concepts related to the value of the month safety. Review of Balanced Score Card, recognition of everyday heros within the system, epic update and ED work culture presentation. Marth 24th, 2014 Attended cath lab safety and quality meeting - review of quality measures for the cath lab: ICD guidelines. AMI core measures and performance, PACU epic progress update. Ortho floor update on SCIP measures , HCAHPS, staffing and work culture 4.0 2.0 13.0
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June 14, 2013 Attended rounds with neurology group (attending physician, residents, pt's nurse and case manager) to evulate and discuss the plan of care for patients with new admission or new diagnosis such as MS or Myasthenia Gravis. September 23, 2013. Attended a collaborative Case Conference to discuss the treatment and planned outcome for a complex case of a 16 y.o. patient diagnosed with DKA and Duchenne Muscular Distrophy Jan 06, 2014 Partcipated in morning rounds with other members of the team (attending, charge nurse and case management) to develop and implement care plan for the day. February 3, 2014. Attended a staff meeting to discuss the process for discharge phone call initative (to ensure that the patients are doing well after beind discharged from the unit. March, 3 2014. Rounding with staff to adress concerns related to EPIC and patient care, resovling pending issues related to documenation. March 18, 2014. Attended an update meeting on ANP being on staff for 24 hours in the ICUs. March 19, 2014 Participated in a meeting involving a physician that has several complains from staff March, 20, 2014 Attended patient rounds with multidisciplinary team to address patient plan of care, based on physicians orders and the plan for discharge March 20, 2014 Participated in completion of mid-year evaluation with preceptor for the PCU staff, discussed competencies, results from peer review, self -review and short-term goals of the organization (patient satisfaction scores, score boards, patient safety and quality measures) June 14, 2013 Meeting with other member of the team (unit charge nurses, clinical operations director, and case managers) to review potential readiness for discharge and develop a plan to address issues that are pending October 4, 2013. Reviewed "code sheet" of the two units to identify and collect information needed for the hypothermia research study (THAPCA) Therapeutic hypothermia after pedicatric cardiac arrest trials. February 10, 2014. Participated in evaluating patient care and adressing discharge issues for a cohort of 5 different patients (Neuro and PCU patient population) Completed assesments on patients getting ready for discharge, arranged for follow-up appt,filling prescription, transport to appt, home health care and assistive devices.
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March 12, 2013 Patient Quality and Safety Committee Participated in the meeting that covered evidence based practice implementation to all patient population, patient experience in the hospital, Quality measures, Pediatrics quality programs, Orders managed by non-physicians and what are the standing protocols. The implementation of the new EMR September 23, 2013 Attended Rounds on 10 Cardiac PICU patients to assess immediate needs related to nursing/parent education, or patient care. The team included on-call intervenist, cardiac surgeon, residents, fellows, patient's nurse and parents. Observed internal patterns of communications June 17, 2013 Participated in staff meeting (Neuro ICU). to arrange for future stroke certification exam reviewand develop strategies, how the elegible nurses can receive AANC grants, attend the course, and study the modules needed to pass the test. Dissusion related to Co-chair agendas and who will be responsible for faciliateing future staff meetings. January 10, 2014. Attended an Annual Budget Review meeting for the PCU and telementary units. To evaluate budget needs for the units in the new ficscal year (supplies, equipment, linenfurniture, food and continueing education) March 24, 2014. Attended a meeting on Rapid Response Team utilization and improvement processes. Identified factors such as volume, reason for call, the most likely population involved. March 31, 2014 Participated in improving processes to develop more effective and timely patient transferes between the units. For example, Pacu/ER to PCU in order
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March 13, 2013 Medication Safety Meeting Participated in the discussion on techniques of Epidural administration as related sterile technique from the Operating Room Nurse perspective. Other topics covered included medication shortage and new labels, Review of most prevalent incident reports related to medications safety. Opiate Safety Task Force discussion, potential harm across the system, medication safety index task force update June 14, 2013 Participated in the revision of current policy related to the distraction of intra-venous tPA for patients who are undergoing procedures in the IR suite. October 2, 2013. Participated in review of policies among three areas (hosptial, unit based and department) in order to combine information and establish a universal policy for each topic. February, 17, 2014. Participatedin ED charge nurse meeting to discuss the units policy change in emergency intubation and organization of the airway cart (physician specific) Februrary 21, 2014 Attended a Stroke certification assessment meeting, to discuss the needed changes and standardazation of system wide policies related to stroke protocol. March 17, 2014. Participated in policy review on nursing assistants standard of care on the unit 2.0 March 19, 2014. Participated in efforts in resolving a patient complaint about staff, listening to the patient and adrressing their concerns. 2.0 February 27, 2014 . Wrote an email through the website: https://www.flsenate.gov/Senators/Find to ask Senator Jack Latvala for support in the PCB SCHCWI 1401, a bill to allow ARNP to practice in a full scope independent practice setting. 1.0 March, 31 2014. Primacy of patients interests: Worked with patient admitted for syncope and dehydration. Addressed familys concerns about patient taking too many medications not as prescribed due to lack of judgment. Obtained a complete assessment of home situation and made arrangements for the patient to be dismissed to nursing skill facility. 1.0 4.0 10.0
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January 24, 2014 Conducted interview and shadowed the hosptial's operational director to analyze the internal and external resources available in order to enhance bed flow in the facility.
5.0 Advocacy March 11, 2013 Marcia Porter Clinical Nurse Specialist Operating Room, got to experience and learned how the The Just Culture Algorithm is utilized to solve dilemmas on what to do as a manager when a nurse makes a mistake. What action to take depending on three main domains The duty to produce an outcome (system under control of employee).The duty to follow a procedural rule (system controlled by the employer) The duty to avoid causing unjustifiable risk or harm. Also discussed categorizing of root causes and actions taken by management to ensure justices to the employees. October 10, 2013. Worked on "How to be a parent in the PICU" brouchure, by gathering evidence based articles and reviewing pediatric literature. February 24, 2014 Participated in webinar for CNL certification review. To find out about the requirments for March, 27 2014. Spoke at staff meeting to give nurses an update information collected during Patient Safety Conference 4.0 14.0 12.0 75.0
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March 13/2013 Met with Judy Milne Patient Safety Officer. Learned more in detail about the patient safety programs at Duke Harm reduction and error prevention programs Infrastructure of the staff involved in patient safety and quality Culture Development and Sustainment June 10, 2013. Attended a meeting with Clinical Nurses IV to discuss pending issues on the neuro units and try to find a resolutions. Topics covered Clinical ladder resources for interested staff, holiday time off, covering shifts and changes to come related to the move and new EHR system. November 11, 2013 Participated in CNS professional meeting in the organization February 3, 2014. Attended a committee meeting to encourage nurses to participate in the clinical ladder and certification process (gathered information and ideas that will motivate staff) March 13, 2014. Attened the 9th Annual Duke Medicine Patient Safety and Quality Conference (system-wide evidence based poster presenations by staff in categories such as safety, education, process improvement, learned award and innovation).
4.0 Member Profession October 10, 2013. Worked on "How to be a parent in the PICU" brouchure, by gathering evidence based articles and reviewing pediatric literature. Janury 06, 2014 Particpated in the interview process for full time RN on the Progressive Care unit March 27, 2014 Participated in development of plan for a patient with multiple chronic diseases to establish knowledge in disease managment and to promote optimum daily functionioning. 6.0
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2.0 May 31, 2013 Monitored progress of staff nurse, who has been reported to the Board of Nursing for unsafe practice. Through shadowing experience, assessing improvement in critical thinking skills and compliance with assigned modules from the board. Served as support and resource person to promote patient safety. January 10, 2014 Attended bed placement rounds meeting. To monitor and anticipate discharge and transfer needs.
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March 21, 2014 Participated in the assessment of patient population who are most risk for falls on the unit, consider factors such as number and type of blood pressure medication, admitting diagnosis and mobility (use of assistive devices). Other factors also considered age, medical history and past falls. The information utlized for research poster idea and to reduce falls that will impact patient safety and cost savings on the unit
3.0 November 18, 2013. Participated in "Parent Advisory Conference" where familes of children who spent several months in the PICU talk about their experience and share helpful tips with the attending and fellows on the units on what would be make their experience much better and how to incorporate the family center care.
3.0 Team Manager September 23, 2013. Attended pressure ulcer data review meeting to address current increased incidence of pressure ulcers in pediatric population on the units mostly related to medical devices. The meeting exemplified communication between the wound care managment staff, unit managers, director, staff nurses and respiratory January 24, 2014. Participated in the development of the new daily staffing sheets for the unit to help organize and simplify the process. March, 18, 2014. Liatt spratt update meeting to discuss the challenges and address concerns of the new system 0.0 4.0 5.0 13.0
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November 11, 2013 Participated in weekly patient conference related to a complex cerebral hemorrhage pediatric patients and how to better manage and treat the population with in a specific time frame January 24, 2014. Participated in the utilization of the PDSA Cycle to approach one of the current projects on th unit. February 07, 2014. Reviewed requirments for rehire process, including labor and productivity data. March 7, 2014 Participated in mid-year staff evaluations to assess the needs for nursing improvement. March 18, 2014 Overview of daily nursing board (to audit for overdo meds, vitals signs etc), verification of patient status report. March, 20, 2014 Attended a meeting to discuss research ideas for safety and quality conference posters 2015. Overview of initial stages of abstract submission covered. March 20, 2014 Participated in completion of mid-year evaluation with preceptor for the PCU staff, discussed competencies, results from peer review, self -review and short-term goals of the organization (patient satisfaction scores, score boards, patient safety and quality measures) March 28, 2014 Participated in disciplinary action process for two employees who failed to maintain bls and
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March 13/2013 Executive Management Committee meeting. Learned about Physician burnout as related to Health Care Reform, enhancing caregiver resilience courses and the tools utilized. June 7, 2013. Evaluated the concerns and needs of staff and patients during a mock-move to a new Pavilion Center that will open in 1 month, to determine possible complications such as, safe patient transfer (correct patient to correct room) availability of medications that are need right away, secure transfer of belongings adaptation process to new equipment and building layout. October 10, 2013. Particpated in a conference to discuss details (budget, ceu's, food) in setting up a "Diabetes in 21st century. Are you up to date? Four hour seminar offered to healthcare providers. January 06, 2014. Manage staffing needs around EPIC training classes. January 10, 2014 Discussed the details for EPIC readiness project to enhance nurses morale and decrease anxiety related to changes in electronic health record charting January, 13 2014. Participated in the PCU Staff meeting to discuss topics such as teamwork and recognizion of staff for their excellene to nursing, standards and expecations for NA's, and ommunication survey. February 24, 2014. Designed and implemented a project on the idea to improve efficiency and decrease stress among nurses during go live with Epic. Created communciation boards at the nurses station for concerns and issues related to EPIC, that could be managed on daily basis. March 3, 2014 Assessed the success of the implementation during morning huddle and
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March 12, 2013 Operations Leadership/patient safety and quality meetings. Participated in this meeting to learn how members of the multidisciplinary team that include: case managers, medical directors, physicians, pharmacy director and chief nursing officer manage care of patients with a hospital stay longer than 30 days or frequent readmission patients due to complex disease process, lack of community resources or inefficient family support March 22, 2013 Safe choices courses for managers provided me with tools to enhance the safety culture in my own practice. Topics Included: Culture of Safety within the hospital system Experiencing Medical Errors Behavioral choices and Just Culture Risk/Incentives ExerciseEvent Analysis and Report out of Case Studies audience participation October 10, 2013 Met with nurse clinicians of the pediatric bone marrow transplant to discuss new order sets for physicians in that department based on best evidence based practice and patient needs March 18, 2014 Patient Rounds with the multidisciplinary team 14.0 March 28, 2014. Evaluated literature and developed a plan to help reduce number of patient interruptions during night shift. Analyzed the factors contrubuting to noise level and reasons for frequent entry to patients rooms. 3.0 March 12/2013 Root Cause Analysis meeting with the staff and patient safety Officer to discuss and analyze an event of mislabeled pathology specimen. Learned about what takes place in RCA who is involved, sequence of events, mistakes, policies that would support the case and action plan to prevent it from happening in the future. March 13/2013 Marie McCulloh Patient Safety Office Root Cause Analysis Matrix The techniques to master the RCA analysis, developing action plan and revising of Policy. Discussion related to Organizational performance improvement and patient safety plan. October 4, 2013 Worked with the preceptor to analyze a clinical issues on the unit (mislabled specimens in the cardiac PICU and PICU) develop a power point presenation based on analysis of contributing factors, and action plan. This presenation was introduced at the managers meeting (system wide). March, 20, 2014 Investigated SRS reports for variety of issues such as controlled substance discrepancy, falls and medication errors. Utilized hospitals processes to address the events. March 21, 2014. Assessed the medication error for peritoneal infusion fluid through careful review of SRS and situation leading up to the mistake. Glitch in the new \\vboxsrv\conversion_tmp\scratch_5\220676152.xlsx.ms_office EMR system (solution was not listed in the MAR to be scanned before administration) as a result, the nurse 2.0 3.0
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presenation based on analysis of contributing factors, and action plan. This presenation was introduced at the managers meeting (system wide). AACN CNL End-of-Program Competencies Required Clinical Experiences March, 20, 2014 Investigated SRS reports for variety of issues such as controlled substance Completed discrepancy, falls and Hrs 6777 Date & Examples of Experiences Hrs Hrs Hrs medication errors. Utilized hospitals processes to address Quality 6775 Res 6776 6773 the events. Adv Ed Resid March 21, 2014. Assessed the medication error for peritoneal infusion fluid through careful review of SRS and situation leading up to the mistake. Glitch in the new EMR system (solution was not listed in the MAR to be scanned before administration) as a result, the nurse administered regular solution versus low-calcium solution as ordered. Communicated with other members and the EMR company to importance of adding the solution to the MAR to prevent future mistakes.
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March 12/13 Worked with Pediatric ICU CNS related to their latest project March Tammy Uhl Pediatric ICU Clinical Nurse Specialist Shadowed Tammy and participated in her latest Performance Improvement Project on the Unit related to mislabeling blood specimens (mismatch between patient labels and requisition forms) covered challenges faced during the project, the plan of resolution and the outcome. Also attended Safety Pediatric Unit Meeting where they reviewed safety reports, Infection rates review and new prepared heparin dosage syringes. November 18, 2013 Reviewed and obtained annual data for "Mislabeled labs presentation" to create a power point for PSQC (Patient Safety and Quality Committee) January 13, 2014. Attended a meeting to establish the criteria for developing quaterly mock codes in the unit March 17, 2014 Participated in a meeting with multidisciplinary team to address the issue of Respiratory technicians to nurse communications and how to effectively improve the relationships. March 19, 2014. Created a required power point presentation to request approval for filling an open staff position, information included labor and productivity for the unit and explanation for FTE variances
11.0 Systems Analyst 25.0 0.0
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March 15/2013 Malissa Mulkey Neuroscience Clinical Nurse Specialist. Spend time shadowing Malissa on her units, exploring the responsibilities of her role, latest projects such as monthly new grad nurse meeting to help them cope in the new position and encourage nurse retention, Research projects related to mobility of the neurosurgical patients, learning tricks of the trade on how to implement a performance project so that the nurses on the unit wont loose interest. Ways to obtain funds needed for new projects on the unit. June 7, 2013. Attended meeting with the CNL leads to establish agenda for the following gatherings, analyzing role performance of CNS within the organization and their involvement in the opening of the new building, Review of guideline improvements required to be compliant with current practice January 23, 2014. Observed a rapid response on the unit, and helped to desing and implement new processes to impact better outcomes in emergency situations. January 31, 2014. Developed a plan of care for discharge of three patients on the PCU. Worked through conflicts involving needs for home health, hospice, arrangment for medications, warm clothes and family miscommunications. March 24, 2014. Participated in a meeting on falls reduction initiative. Overview of falls bundle (yellow arm band, socks, placement of fall sign on door box) compliance and use of video monitoring on high-risk patients, utilization of fall audits and bed alarms 2.0 4.0 3.0 16.0
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June 10, 2013. Participated in a meeting debate among several of the system's CNS nurses, to discuss the affiliated universities' CNS program goals and spheres of influence as related to nursing strategic model. Strong CNS influence vs. shared governance system. Role of unit based CNS March 15/2013 Attended 8th annual Patient Safety and Quality Conference Full Day of speaker presentations that included: Presenter: Gerald B. Hickson, topic: Balancing Systems and Individual Accountability in a Pursuit of a Culture of Safety Presenter: Peter G. Napolitano Bedside to Battlefield: Exploring evidence of team effectiveness in a high-stress environment.Poster presentation on quality and safety improvement projects completed throughout the year within the system.The Duke Resilience Mini- Course Patient-Centered Communication=Communicating Safely, Communicating Safety October 2, 2013. Reviewed SRS reports with direction of the preceptor, by seperating them into type of incident for the entire month of September . Develop a poster based on that information to display in the units lounge, For nurses to review. Total of 75 reports. November 18, 2013 Participated in Cardiac PICU rounds to determine the needs for current patients on the unit (including social help, discharge, emotional support and education) January 17, 2014. Attended a meeting to evaluate and create approprite nursing assistant competancies based on hospital policies. February, 17, 2014 Participated in charts audits related to the implementation of Lien-Spratt method (checking proper calculations and documentation to opimize
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June 17, 2013. Attended DUHS Neuroscience Advanced Clinical Practice Council meeting (system wide with clinical leaders, unit manager and CNS for all ICU's), to disuss and implement policy revision as related to several nursing skills (Lumbar drain protocol, hypothermia, and DHE policy for tx of migraines). Overview of criteria for comprehensive stroke certification survery (challenges and goals). October 10, 2013. Participated in PICU interdiciplinary rounds to discuss pending issues for each patient and how to best solve them with the incorporation of EBP January 13, 2014.. Participated in development of work culture action plan with the goal to improve morale and teamwork on the unit.
6.0 Clinician May 24, 2013 Participated in a meeting with nurse research scientist and the CNS of Neuroscience at the organization to review the concepts of a new research study that will explore delirium in medical patients vs. delirium in neurological patients. Topics covered: budget for the study, goal when completed, measurement tools, time and staff involvement. Technology resources such as EEG monitoring. October 10, 2013. Conducted a review of criteria for the THAPCA trials and participated in the assesment of the patient during the trial January 20, 2014. Participated in obtaining evidencebased literature on the topic of "decreasing the freqency of nightly vial signs checks in low risk population on the unit". March 28, 2014 Attended Medication Management meeting to discuss med safety index indicator, processes in improving vaccines administration. Alaris pump guardrails usage, chemotherapy orders meeting policy requirements. 12.0 14.0
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March 12/2013 - Met with Micheal Alton Administrative Director of Performance Improvement (Womens and Childrens) Overview of patient safety and quality incentives employed the by Womens and Childrens Hospital in the last decade. 1) Core Safety Teams higher up and reporting to senior management on committees. 2) Medication Safety Teams made of multidisciplinary members, identify and make changes. 3) Safety Walk rounds- asking nurses about safety concerns related to equipment or the system itself 4) Local Safety Teams available directly on the units 5) Transport teams Also discussed the current challenges to provide safe care in nursing (size complexity, standards and regulations required to function, technology malfunctioning) May 31, 2013 Coordinated care for a patient who was admitted with mysthesia gravis and was in the need of speech therapy to help assist her with those concerns February 7, 2014. Developed employee rounding log to be utlized for management to as a tool for nurse satisfaction and staff retention. March 28, 2014 Attended Patient safety and Clinical Quality Committee patient safety issues addressed through review of evidence-based care related to SCIP measures (antibiotic timing, selection and misses, beta blockers, VTE prophylaxis, hair removal, foley removal, perioperative temperature). Overview of failure to rescue case study project as related to missed patient change of status that related in surgical procedure. March 28, 2014 Attended a stroke evidence based care meeting to discuss recent core measures report results
4.0
2.0
12.0
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March 12/2013 Susan Freeman Diabetes Program Clinical Nurse Specialist Discussed and learned about the role of CNS within the Diabetes program, the challenges, successes and responsibilities that this type of CNS has to endure. Learned about the complexity of the program, latest changes related to insulin pens and procedure changes. Hypoglycema champion project. January 03, 2014. Review of monthly HCAPS, value based-purchasing, balanced-score cards and code carts logs. Created visual graphs and postcards to display in the unit
2.0 May 24, 2013 Participated in a meeting to discuss strategies in building an effective Webinar conference that will help to improve leadership skills among the NICU managers. March, 11 2013 Margaret Sturidivant Administrative Director for Patient Safety Learned from Margaret and completed a webinar on a safety tool Team STEPPS utilized by DUHS. This particular class was related to Team STEEPS for patient and family engagement in their care. Main objectives helped practitioners how to teach patients and their families to befocused on the healthcare system, partner with patients, and encourage patient to take on an active role. Guiding Principals Patient and family centeredrounding 4.0 Outcomes Manager 10.0 2.0 8.0 3.0
4.0
22.0
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October 4, 2013. Participated in the rounds, by observing and asking questions related the patient care and communication among the providers. January 20, 2014. Participated in organization and presenation of educational seminar on "Peritoneal Dialysis" audience ER charge nurses. Part of the crosstraining project initative. February 17, 2014. Co-presented a seminar with a case study on new Alteplase (tPA) adminstration protocol. March 14, 2014 Participated in the senior management morning rounds to address communication and partnering between patients and staff. focusing on the patientcentered care model.
2.0 November 11, 2013 Conducted research and colloborated with members of the disipline to develop the "How to Parent in the PICU brouchure". Created the brouchure based on the information January 03, 2014. Completed research on culture awerness facts (Jewish population) and put together a weekly newletter for the staff. February, 14, 2014. Participated in the educational seminar for the diabetic population. Implementation of the Adult Insulin Intravenous Nomogram Lien-Spratt Method (education included, physicans orders, calculations for bolust and drip titration and proper documenation. February, 21, 2014 Attended a Cancer Center Tumor Conference, focused on multidisciplinary approach to provide appropriate treatment for complex cancer patients.
11.0
5.0
12.0
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May 31, 2013. Collaborated with the Operational Clinician of Neuroscience and the general orientation Educator nurse, plan for effective scheduling of "Intro to neuro course" and neuro core modules that will assist nurses who are new to the unit or new grads to have a stronger knowledge base in order to practice safely and effectively in the neuroscience environment. September 23, 2013. Created Poster Presentation on the topic of "Incidence of pressure ulcers in children" to be presented to nursing staff during Skills Day. January 17, 2014. Participated and faciliated annual staff competency fair to meet unit's skill requirments. January 27, 2014 Participated in preperation meeting for the new electronic health record system implementation. March 31, 2014. Provided patient education during "fall huddle" to a patient who experianced a fall to prevent future incidents.
4.0
3.0
11.0
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June 7, 2013. Meeting to coordinate upcoming Critical Care Nurse certification prep course, facilitate the time and place for when it will be offered and taught by the current CNS October 2, 2013 Participated in "Shock Lecture" during orientation of new nursing staff in the pedicatric units. January 03, 2014. Worked on "Employee appriciation board" to recognize staff for their hard work and complements from the patients and coworkers January 17, 2014. Participated in development of education posters and competency for cross training project. Topic "nephrostomy tube" education for patients. January 10, 2014. Attended a meeting on value-based purchasing (the goal of the meeting to brainstorm for ideas related to boosting of patient satisfaciton scores related to MD communications). February 28, 2014. Participated in an all day go live for Epic campaing, Attending meetings, last minute check (specimen label printers in each room. input of data. staff support) assessing readiness, logisitcs workflow impact and encouring teamwork. March 28th, 2014 Attended Educational seminar for nursing assistants on 12 lead EKGs
2.0
3.0
22.0
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June, 10, 2013 Consulted new hire nurses for their 6 week follow-up to ensure their competencies and orientation paperwork is up-to date and to discuss any potential stressors, or difficulties that they might of encountered at this time of their orientation. September 23, 2013. Met with other staff members to discuss an educationl plan for delirium incidence in pediatric population March 3, 2014. Discussed a simulation of cardiac arrhythmias in hospitalized patient to measure to measure and improve response time project based on evidence based research March 7, 2014. Attended a meeting on ideas to incorporate diversity within the unit. a world map was posted in several areas of the unit, so staff could write in their orgin location and where they traveled. This project encouraged dissucsion among the staff and commonalites and differences between cultures. March 14, 2014. Participated in a hospital wide meeting to discuss the culture/work climate in the units, and brought up ideas on how to enhance safety awareness. March 17, 2014 Attended a meeting to discuss new education ideas for the staff. Organization of mock codes, ECG classes and Med-Surge certification
4.0
2.0
14.0
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May 24, 2013.Participated in a electronic health record course taught by the CNS to assist with the transition to a new program that will be implanted system wide May 24, 2013 Participated in a electronic health record course taught by the CNS to assist with the transition to a new program that will be implanted system wide November 11, 2013. Participated in a continuing eduation lecture "ECG interpretations and cardiac pathophysiology in pediatric population". Target audience. Experianced nurses who needed a refreshment course. Janury 06, 2014 Participated in a meeting related to "cross training project" an initative to train staff to be able to float to PCU, Neuro and ICU units. March 7, 2014. Staff training on TST competancies and PPD placement, to increase number of nurses who can particpate in annual check offs. March 10, 2014 Attended a seminar on topics such as peer-to-peer hostility, and creating a and leading a collegial interative team. Focus of sessions on leadership, safety and quality. March 17, 2014 Attended a meeting to discuss new education ideas for the staff. Organization of mock codes, ECG classes and MedSurge certification
8.0 Educator 0.0 18.0
2.0 17.0
19.0 89.0
Total CNL Hours by Course
60.0
64.0
65.0
301.0
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Bockowski Complete CNL Clinical Hours Spring 2014

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Bockowski Complete CNL Clinical Hours Spring 2014

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AACN CNL End-of-Program Competencies Required Clinical Experiences Graduate Level CNL Role CNL Role End of Curriculum

Advocates for the profession

Effects change in health outcomes

Speak at a public engagement to a public forum.

Care Environment Management

Monitor/delegate care in the patient care setting.

Care Environment Management

Uses information systems / technologies

Systems Participates in Analyst / Risk system reviews Anticipator

Evaluates / anticipates client risks to improve patient

Apply evidence-based practice as basis for client care decisions

Clinical Outcomes Management

Uses current information/ materials/ techniques

Conduct health education of individual patient or cohort based on risk profile.

11.0 Systems Analyst 25.0 0.0

8.0 Educator 0.0 18.0

Total CNL Hours by Course

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