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					Volume 34 • Issue 2                                                                                                                                                       May, June, July 2009




                              Reporter The Official Publication                       of the Delaware Nurses Association

                                                                           Constituent member of ANA
              The mission of the Delaware Nurses Association is to advocate for the interest of professional nurses in the state of Delaware. The Delaware Nurses
             Association is dedicated to serving its membership by defining, developing, promoting and advancing the profession of nursing as an art and science.


                                                                         Inside DNA REPORTER

                                                                                                                                                          Delaware Cultural
                                         Key Legislative Issues                                                                                        Competency Education
                                               to Watch                                                                                                       Series
                                                 Page 7                                                                                                            Page 13



   Guest Co-Editors                                                                                                                     Executive Director’s
                      Nursing Education
                                                                                                                                                   Column
                                                                                                                                                                             Sarah J. Carmody
                                                                                                                                                                             Executive Director
  Tish Gallagher earned her                                       Veronica      Wilbur     has
  BSN and MSN from the                                            28      years     experience                                                                       Wow! The first half of 2009
  University of Delaware and                                      as a registered nurse.                                                                          is already gone and the DNA
  her PhD in Nursing from                                         Her     previous     practice                                                                   has already accomplished
  Widener University. She is                                      background includes 15                                                                          so much. Many of the goals
  a Certified Nurse Educator                                      years in medical intensive                                                                      outlined in the last issue of
  (CNE). Tish has worked                                          care, coronary intensive                                                                        the Reporter have/are coming
  for the State of Delaware                                       care and emergency room                                                                         to fruition.
                                                                                                                                           Sarah Carmody             In     March,   the    DNA
  as both a Public Health                                         nursing. As a family nurse
  Nurse and a Developmental                                       practitioner for 13 years,                                                                      submitted our proposal for title
  Nurse Specialist. She has                                       she has experience in                                                 protection to the Board of Nursing for consideration.
  also been an Assistant                                          family primary care and                                               The intent of protecting the title “nurse” is to protect
  Professor at the University     Tish Gallagher                  walk-in     medical     care.  Veronica Wilbur                        the public from individuals who are not nurses, yet
  of Delaware. Since 1990,                                        Her areas of expertise in                                             deceitfully lead the public to believe they are nurses
  she has been employed by Wilmington University                  teaching include pathophysiology, adult assessment                    and have the education and skills of a registered nurse
  and has been Dean of the College of Health                      and teaching theory. She also has a special interest                  or licensed practical nurse. The regulation of nurses
  Professions there since 2001. Tish can be reached               in the area of cultural competency and nurse                          by the Board of Nursing offers some assurance to the
  at tish.b.gallagher@wilmu.edu or at 302-356-6916.               practitioner students.                                                public that a nurse is competent to provide services
                                                                                                                                        in an effective and safe way. Restricting use of the
                                                                                                                                        title “nurse” to those who have satisfied the licensure
   Nursing education is critically important as health       education around the state. We have selected articles                      requirements ensure the protection the public deserves
care moves into the next decade and beyond. In spite         that highlight educational innovation in academia                          and affirms the value of nursing. We are hopeful
of local trends to freeze positions and possibly lay off     and practice. The articles range from discussion of                        that Delaware will soon join the 24 other states that
nurses, there is still a projected shortage of 500,000       accreditation, advance practice nurse educators, to                        currently have this protection.
nurses by 2025 (1). The nurse educators in academic          implementing patient safety standards in the hospital                          The APN Council of Delaware has re-opened its
and clinical settings prepare nurses of the future.          setting. The common theme in all of these articles is the                  bid to allow APNs to prescribe accessible parking
Therefore, the importance of nursing education cannot        role of the nurse educator.                                                placards and/or plates for qualified individuals with
be over emphasized.                                                                                                                     disabilities. This is an exciting and necessary step in
   This edition of the DNA Reporter highlights nurse            1. Despite Surge of Interest in Nursing Careers, New                    the continuing care of the patient care population.
educator authors from across the State of Delaware–          AACN Data Confirm that Too Few Nurses are Entering the                         The DNA has added a new benefit for members.
both academic and clinical educators have contributed        Healthcare Workforce. 26 February 2009. http://www.aacn.
                                                             nche.edu/Media/NewsReleases/2009/workforcedata.html                                    Executive Directors Column continued on page 2
and describe some of the innovations in nursing




                                                 Presort Standard
                                                   US Postage           Executive Director’s Column . . . . . . . . . . . . 1            Call for Nominations for Elective Office . . . 11
                                                    PAID                President’s Message . . . . . . . . . . . . . . . . . . 3        Nurse Educator: Clearly an Advanced
                                                   Permit #14
                                                  Princeton, MN
                                                                        News from the Board of Nursing . . . . . . . . . 4                  Practice Role . . . . . . . . . . . . . . . . . . . . . 12
                 current resident or                  55371             Upcoming Events . . . . . . . . . . . . . . . . . . . . 5        If Nursing is a Sea of Possibilites,
                                                                        Excellence in Nurse Practice Awards                                 Why Am I Still Adrift? . . . . . . . . . . . . . . 12
                                                                          Application . . . . . . . . . . . . . . . . . . . . . . . 6    Delaware Cultural Competency
                                                                        Delaware Cultural Competency                                        Education Series . . . . . . . . . . . . . . . . . . 13
                                                                        Key Legislative Issues to Watch . . . . . . . . . . 7            Data Bits . . . . . . . . . . . . . . . . . . . . . . .15-16
                                                                        Facing the Challenge of Retention . . . . . . . . 8              Welcome New and Reinstated Members! . . 17
                                                                        Implementing Standardized Colors for Patient                     DNA Membership Application . . . . . . . . . . 18
                                                                          Alert Wristbands . . . . . . . . . . . . . . . . . . 11
Page 2 • DNA Reporter                                                                                                                                         May, June, July 2009
Executive Directors Column continued from page 1
The DNA has partnered with InsureEZ to offer our
members the best rates in the marketplace for health
and dental insurances, term life insurance, auto and
homeowners insurance as well as other programs.
Please visit www.insureEZ.net/dna or call 1-888-
744-2121. The DNA will continue to add to our list of
benefits. If there is a product or service you would like
                                                            Vision: The Delaware Nurses Association is dedicated to
                                                            serving its membership by de ning, developing, promoting
                                                            and advancing the profession of nursing as an art and
                                                                                                                                         Reporter
                                                            science.                                                                         OFFICIAL PUBLICATION
the DNA to investigate for a benefit, please give me a
                                                                                                                                                       of the
call or send an email to sarah@denurses.org.                Mission: The Delaware Nurses Association advocates for the                    Delaware Nurses Association
    Congratulations to the Professional Development         interest of professional nurses in the state of Delaware.                        5586 Kirkwood Highway
and Continuing Education committees! Thanks to                                                                                                Wilmington, DE 19808
the efforts of both committee members, the DNA was          Goals: The Delaware Nurses Association will work to:              Phone: 302-998-3141 or 302-998-3142 FAX 302-998-3143
re-accredited as an ANCC provider and approver of            1. Promote high standards of nursing practice, nursing                       Web: http://www.denurses.org
nursing continuing education for the next four years.           education, and nursing research.
                                                             2. Strengthen the voice of nursing through membership            The DNA Reporter, (ISSN-0418-5412) is published 4 times
Great work!                                                                                                                   annually, by the Arthur L. Davis Publishing Agency, Inc., for
                                                                and af liate organizations.
    The DNA has moved forward with partnering                3. Promote educational opportunities for nurses.                 the Delaware Nurses Association, a constituent member
other organizations to provide quality continuing            4. Establish collaborative relationships with consumers,         association of the American Nurses Association.
education for the nursing community. The Professional           health professionals and other advocacy organizations.
                                                                                                                                              EXECUTIVE COMMITTEE
Development committee has collaborated with the              5. Safeguard the interests of health care consumers and
                                                                nurses in the legislative, regulatory, and political arena.   President                 Treasurer
Delaware Health and Social Services, the Delaware
                                                             6. Increase consumer understanding of the nursing                Norine Watson, RN,        Gloria Zehnacker, CRNA, APN
Academy of Family Physicians, the Delaware Academy                                                                            MSN, NEA-BC
of Medicine and the National Medical Association to             profession.
                                                             7. Serves as an ambassador for the nursing profession.
bring you the Cultural Competency Series which runs                                                                           Past President                      Secretary
                                                             8. Represent the voice of Delaware nurses in the national        Penelope Seiple, RN,                Vacant
from March to May. They have also done a great job              arena.                                                        MSN, NE-BC, FACHE
pulling together the spring APN and DNA conferences
into one event with ANA President Becky Patton as the                                                                                          COMMITTEE CHAIRS
keynote speaker.                                                                                                              Continuing Education    Advanced Practice
    The DNA will be working with DTCC-Georgetown
campus to develop the Fall DNA conference. Thank you        Upcoming Reporter                                                 Nancy Rubino, EdD, RNC
                                                                                                                              (Acting)
                                                                                                                                                      Leslie Verucci, MSN, RN,
                                                                                                                                                      CNS, ARPN-BC, CRNP


                                                                Themes
to Kelly Davis, DTCC instructor and DNA delegate for
                                                                                                                              Nominating                          Professional Development
proposing the collaboration and to those DNA members                                                                          Moonyeen “Kloppy”                   Karen Carmody, MSN,
working to make this a fantastic event. Mark your                                                                             Klopfenstein, MS, RN,               CRNP
calendars for October 22, 2009!                                                                                               IBCLC, CPUR
    This is an election year for president-elect, three     • August/September/October—
                                                                                                                              Legislative                         Communications
ANA/DNA delegates, secretary and for members of the             Technology and Nursing                                        Ann Darwicki, RN                    Heidi LeGates, MSN, RN,
nominating committee. Please consider running for           • November/December/January 2010—                                                                     NEA-BC
office. It is a great way to meet colleagues from around        Palliative Nursing                                                                                Bonnie Osgood, RN-BC, MSN,
the state and to make a difference in the direction of      • February/March/April 2010                                       Environmental Ad-Hoc                NE-BC
the Association. Qualifications and details of each             Health Care Economics                                         Michelle Lauer, RN, MSN, BC
                                                                                                                              Nursing Healing Our Planet (NHOP)
position can be found on the website under the “about”
tab. Winners will be announced at the Fall 2009                                                                                   DNA DELEGATES to the ANA House of Delegates
conference.                                                                                                                           New Castle County: Nati Guyton, RN, MSN
    The NHOP group also has scheduled two more                                                                                          Kent County: Karen Panunto, RN, MSN
Medicine Take Back events this year supported by                                                                                         Sussex County: Kelly Davis, RN, MSN
local hospitals. The April 23rd event was held at                                                                                DNA President: Penelope Seiple, RN, MSN, NE-BC, FACHE
Christiana Care Hospital and the June 1st event will                                                                                              Alternates-at-Large:
                                                                                                                                                 Marianne Ford, RN, MS
be held at Bayhealth Medical Center. Thanks to all of                                                                                          Betty Stone, RN, MS, OCN
the volunteers, the DEA, law enforcement and all those                                                                                        Diane Talarek, RN, MA, CNA
who give their time and resources to make these events
possible. A special thanks to Christiana Care Hospital                                                                                                Executive Director
and Bayhealth Medical Center for supporting these                                                                                                   Sarah J. Carmody, MBA
events. Without their support these Medicine Take                                                                                                     Office Assistant
Back events would not be possible.                                                                                                                 Rosemary Finlayson, BS
    And lastly, the Delaware Nurses Association license
plate. I am hoping that by the time this issue has                                                                            Subscription to the DNA Reporter may be purchased for $20 per year,
                                                                                                                              $30 per year for foreign addresses.
been printed and distributed, the application will be
available for DNA members to apply for the very first                                                                         Acceptance of advertising does not imply endorsement or approval
Delaware license plate supporting nursing. The first                                                                          by the Delaware Nurses Association of products advertised, the
                                                                                                                              advertisers, or the claims made. Rejection of an advertisement does
20 numbers will be retained for a silent auction with

                                                               Happy Nurses
                                                                                                                              not imply a product offered for advertising is without merit, or that the
proceeds to support the development of the Delaware                                                                           manufacturer lacks integrity, or its use. DNA and the Arthur L. Davis
Nursing Foundation and education scholarships. In                                                                             Publishing Agency, Inc. shall not be held liable for any consequences
                                                                                                                              resulting from purchase or use of an advertiser’s product. Articles
order to get this first ever Delaware nursing license

                                                                  Week!
                                                                                                                              appearing in this publication express the opinions of the authors; they
plate, you must be a DNA member. Thank you to Chris                                                                           do not necessarily re ect views of the staff, board, or membership of
Foard for his infectious enthusiasm for this project and                                                                      DNA or those of the national or local associations.
for helping to make it happen.                                                                                                Advertising Rates Contact—Arthur L. Davis Publishing Agency,
                                                                                                                              Inc., 517 Washington St., P.O. Box 216, Cedar Falls, Iowa 50613,
                                                               National    Nurses     Week     is                             800-626-4081, sales@aldpub.com. DNA and the Arthur L. Davis
                                                                                                                              Publishing Agency, Inc., reserve the right to reject any advertisement.
                                                             celebrated annually from May 6,                                  Responsibility for errors in advertising is limited to corrections in the
                                                                                                                              next issue or refund of price of advertisement. Material is copyrighted
                                                             also known as National Nurses Day,                               1997 by the Delaware Nurses Association and may not be reprinted
                                                                                                                              without written permission from DNA.
                                                             through May 12, the birthday of
                                                             Florence Nightingale, the founder of                                                   Managing Editors
                                                                                                                                            Heidi LeGates, MSN, RN, NEA-BC
                                                             modern nursing.                                                               Bonnie Osgood, RN-BC, MSN, NE-BC

                                                               Happy Nurses Week to all those                                                            Photographer
                                                                                                                                                  William Campbell, EdD, RN
                                                             who make a difference in their
                                                             patients lives and are committed                                 The DNA Reporter welcomes unsolicited manuscripts by DNA
                                                                                                                              members. Articles are submitted for the exclusive use of The DNA
                                                             to making a positive change in the                               Reporter. All submitted articles must be original, not having been
                                                                                                                              published before, and not under consideration for publication
                                                             delivery of care!                                                elsewhere. Submissions will be acknowledged by e-mail or a self-
                                                                                                                              addressed stamped envelope provided by the author. All articles
                                                                                                                              require a cover letter requesting consideration for publication. Articles
                                                                                                                              can be submitted electronically by e-mail to Heidi LeGates, MSN, RN,
                                                                                                                              NEA-BC @ Heidi_Legates@Bayhealth.org or Bonnie S. Osgood, RN-
                                                                                                                              BC, MSN, NE-BC, @ bosgood@christianacare.org.

                                                                                                                              Each article should be prefaced with the title, author(s) names,
                                                                                                                              educational degrees, certi cation or other licenses, current position,
                                                                                                                              and how the position or personal experiences relate to the topic of
                                                                                                                              the article. Include af liations. Manuscripts should not exceed ve (5)
                                                                                                                              typewritten pages and include APA format. Also include the author’s
                                                                                                                              mailing address, telephone number where messages may be left, and
                                                                                                                              fax number. Authors are responsible for obtaining permission to use
                                                                                                                              any copyrighted material; in the case of an institution, permission must
                                                                                                                              be obtained from the administrator in writing before publication. All
                                                                                                                              articles will be peer-reviewed and edited as necessary for content,
                                                                                                                              style, clarity, grammar and spelling. While student submissions are
                                                                                                                              greatly sought and appreciated, no articles will be accepted for the
                                                                                                                              sole purpose of ful lling any course requirements. It is the policy of
                                                                                                                              DNA Reporter not to provide monetary compensation for articles.
May, June, July 2009                                                                                                                       DNA Reporter • Page 3

                                                                                                                          What’s New with
   President’s Message                                                                                                    Member Benefits
  Nursing Stays on Course while the World                                                                               Another way Delaware Nurses Association is
                                                                                                                     helping you cut your personal expenses…

          Goes Crazy Around Us...                                                                                       Check out our money saving programs such as:
                                                                                                                     health, life, disability, auto, homeowners insurance
                                                                                                                     & more…
                                Norine Watson               it takes time, money and effort everyone I talk to          Through a partnership with www.InsureEz.
                                DNA President               readily admits that they understood their nursing        net, DNA members are offered the best rates in the
                                                            specialty better after preparing for a certification     marketplace.
                           I read a report recently that    exam. Plus it is impossible to quantify the boost           V i s i t w w w. I n s u r e E z . n e t / D N A o r c a l l
                        indicated that even during the      in professional confidence that goes along with          1-888-744-2121
                        current economic turndown           receiving notification of successfully passing the
                        nursing jobs are still available.   exam. Start to prepare today, you owe it to yourself



                                                                                                                        Wit and Wisdom
                        Nursing salaries are improving      and to those who count on you for their care.
                        and there are opportunities in          Finally think about what you would need to do
                        nursing for professional and        to be the nurse on your unit that your manager
                        clinical advancement.               or supervisor could not do without. Start out by
                             But despite this positive      imagining that your unit is undergoing some
   Norine Watson                                            changes and that your personnel fi le is on your              How wonderful it is that nobody need wait
                         news for Healthcare positions
                         it is still a good time to give    management team’s desk. Would your boss fight to            a single moment before starting to improve the
your career a “once over”. Take these steps to make         keep you on her team? You have control over how             world.
your career risk proof. Start off by reading this           you are perceived at work and some ways to ensure                                           ~Anne Franke
edition of the DNA Reporter carefully and thinking          it is as an outstanding contributor are to support the
about how you might advance your professional               goals of your unit and your department, stay on top            Change will not come if we wait for some
education. I believe it was Florence Nightingale who        of your work email, read articles that are pertinent        other person or some other time. We are the ones
wrote, “we as nurses are never complete”. Don’t             to your specialty, participate in research studies          we’ve been waiting for. We are the change that
think of your bachelor’s degree as your terminal            and join committees. Never hesitate to volunteer            we seek.
professional degree. Consider going back to school to       discretionary effort.                                                           ~President Barack Obama
add a MSN, DNP or a PhD to your credentials. We are             But the most important suggestion I can make is
at our best when we are learning and growing; the           to manage your attitude and your conversations. Try
professional experience that you have gained from           not to bring personal and family problems to work
your career to this point will add a new level of depth     with you and keep your conversations positive and
and understanding to your studies you may not have          focused on the patients that you are caring for. The
experienced with your earlier degrees. Additionally,        words you choose, the level of your conversations and
your professional practice will change in ways that         your approach to your work, be it–“can do” or “ain’t
you can not even anticipate before you get started.         it awful”–are how your peers and your supervisors
   We celebrated National Certified Nurses’ Day on          know you. Making seemingly small changes can
March 19th. With this date and Dr. Gretta Style’s           result in a big change in your professional image.
work in mind, the next career enhancement step I            Your patients, co-workers and management team will
offer is to attain a specialty certification or to help     thank you for taking these steps to be indispensible.
a colleague work to achieve this goal. Even though
Page 4 • DNA Reporter                                                                                                                         May, June, July 2009


   News from the Board of Nursing
                                               Transition to Practice Update
                                                           educational levels of nurses. Once new graduates         January meeting a conference call was held with
     Pamela C. Zickafoose,                                 pass the NCLEX®, they enter the transition               representatives from the American Association
  EdD, MSN, RN, CNA-BC,                                    program. Orientation in this model is considered         of Colleges of Nursing (AACN), American Nurses
  CNE earned her EdD,                                      being instructed on the policies and procedures          Association (ANA), American Organization of Nurse
  MSN, and BSN from the                                    of the workplace, as well as role expectations.          Executives (AONE), National League for Nursing
  University of Delaware.                                  Therefore, orientation is separate from the concept      (NLN), National Association for Practical Nurse
  She is board certified in                                of transition to practice, which is a formal program     Education and Service (NAPNES), University Health
  Nursing Administration                                   designed to support newly licensed nurses during         System Consortium (UHS), and National Association
  and is a Certified Nurse                                 their progression into practice. Once orientation        of Directors of Nursing Administration/Long Term
  Educator. Dr. Zickafoose                                 is completed, the newly licensed nurses enter            Care (NADONA-LTC). These stakeholders provided
  has    over   20    years                                the transition portion of the model. There are           valuable input and were supportive of the transition
  experience in nursing                                    eight transition modules including delegating/           model. Another collaborative call with nursing
  education with positions Pamela Zickafoose               supervising, role socialization, utilization of          organizations/stakeholders will be held at our March
  held     at     Bayhealth                                research, prioritizing/organizing, clinical reasoning,   meeting. One major concern is fi nancial support of
  Medical Center, Delaware                                 safety, communication, and specialty content. These      the model. Therefore, the committee is exploring
  State University and Delaware Technical &                were identified from the literature and are supported    possible funding sources. The evidence does indicate
  Community College. Dr. Zickafoose is a member            by the evidence. These modules could be presented        that effective transition programs reduce costs for
  of the nursing faculty at Delaware Technical &           at the institution where the new nurse works, in a       employers due to reduced turnover and safer care
  Community College-Terry Campus and a relief              shared methodology with other institutions, or via       resulting in more positive patient outcomes.
  staff nurse in ICU at Bayhealth Medical Center.          the Internet. The Transition to Practice Committee          In March 2009, the progress from the January
  She is also President of the Delaware Board of           plans to work with the NCSBN E-Learning                  meeting will be reported at the NCSBN Mid-Year
  Nursing and a member of the National Council             Department to develop web-based learning modules         meeting. The Transition to Practice Committee
  of State Boards of Nursing (NCSBN) Transition            and to facilitate nurse-preceptor relationships.         will meet later in March to continue working on
  to Practice Committee. Dr. Zickafoose can be                The outcomes of the Transition to Practice Model      this year’s charges. It has been suggested and is
  reached at pzickafo@dtcc.edu or by phone at              are based on Quality and Safety Education for            anticipated that a pilot of the transition model will
  302-857-1347.                                            Nurses (QSEN) Competencies: Patient Centered             be conducted before the project is implemented
                                                           Care, Teamwork and Collaboration, Evidence-              nationally. Outcomes data will be collected and
                                                           Based Practice, Quality Improvement, Safety, and         presented to NCSBN’s membership.
   The nurses of Delaware were fi rst introduced           Informatics (Cronenwett, et al, 2007). The time
to the National Council of State Boards of Nursing                                                                  References
                                                           period for the model will be 6 months, although it           Cronenwett, L., Sherwood, G., Barnsteiner, J., Disch,
(NCSBN) Transition to Practice Committee at the            is expected that the new graduate will have ongoing      J., Johnson, J., Mitchell, P., Sullivan, D. T. & Warren, J.
Nurse Educator Update held at Delaware Technical           support for another 6 months. At the end of the year,    (2007). Quality and safety education for nurses, Nursing
& Community College–Terry Campus in June                   the new nurse should be able to successfully meet        Outlook, 55(3), 122-131.
2008. The NCSBN Board of Directors charged the             competencies necessary for safe nursing practice.            Kohn, L., Corrigan, J., Donaldson, M. Eds. (1999). To err
Transition to Practice Committee to: Recommend             In order for the newly licensed nurse to maintain        is human: Building a safer health system. Washington DC:
an evidence-based regulatory model for transition          licensure, s/he will need to provide the state Board     The National Academies Press.
to practice. It was believed there was a need for          of Nursing with a Transition to Practice Verification        NCSBN. (2009). Description of NCSBN’s Transition to
this model because of the tremendous changes                                                                        Practice Model. Sent to Member Boards January 2009.
                                                           (TPV) form, which will be signed by the new nurse            NCSBN. (2008a). Transition evidence grid. Retrieved
in healthcare over the past 20 years which have            and an administrator, attesting that the new nurse       February 16, 2009, from www.ncsbn.org/Final_08_
altered practice and resulted in a greater concern         has met all the requirements of the jurisdiction’s       Transition_grid.pdf
for more safe and effective care. Nursing education,       transition program (NCSBN, 2008b).                           NCSBN. (2008b). Regulatory model for transition to
practice and regulation needed to collaborate on              Besides being charged with developing an              practice report. Retrieved February 16, 2009, from www.
this very important issue. Numerous factors were           evidence-based model to transition new graduates         ncsbn.org/388.htm
related to the need for a transition model including       to practice, the Transition to Practice Committee            NCSBN. (2008c). Toward an evidence-based regulatory
medical errors which have been a major concern             members were also charged to collaborate with            model for transitioning new nurses to practice, in Leader to
for the health professions. The Institute of Medicine                                                               Leader Fall 2008. Chicago, IL: NCSBN.
                                                           Member Boards and stakeholders regarding the                 Spector, N. & Li, S. (2007). A regulatory model on
reported that medical errors kill more people than         future regulatory model, to identify strategies          transitioning nurses from education to practice. JONA’s
breast cancer, AIDS or automobile accidents (Kohn,         for the model, and to develop model rules. At the        Healthcare Law, Ethics, and Regulation, 9(1), 19-22.
Corrigan & Donaldson, 1999). At the same time,
there has been an increased complexity of care for
sicker patients with multiple conditions, a continued
need for systems thinking, and technologic advances,
along with a shortage of nurses and faculty that is
                                                                          Figure 1
expected to continue into the future. Another issue
                                                                Transition to Practice Model
that prompted this transition to practice initiative
was the implementation of computer adapted testing,
which allows new graduates to become licensed
within days of passing the NCLEX®. Previously, new
graduates waited for months for their results thus
working under the supervision of licensed nurses
(Spector & Li, 2007). All of this was the impetus for
the NCSBN to look at transitioning new nurses into
practice, through regulation.
   The Transition to Practice Committee fi rst
explored the evidence and developed an Evidence
Grid (NCSBN, 2008a). The evidence supported the
Transition to Practice Committee’s decision that
post-graduate nurse transition programs protect the
public. Next the committee developed a conceptual
model for transition, which is a collaborative model
that will be implemented through regulation.
Collaboration between education, practice and
regulation is essential for this model to be successful.
Educators are the experts in curriculum design and
evaluation and will be able to assist with the design
of the transition modules. Practice provides that
crucial link that will provide new graduates with
planned practice experiences with qualified nurses
to mentor them. Regulation not only will be able to
enforce the transition program, through licensure,
but regulators will be able to provide new graduates
with information on their scope of practice, the
Nurse Practice Act, and maintaining their license
throughout their careers (NCSBN, 2009).
   Many organizations have implemented transition
programs but not for all settings and levels of
nurses. This Transition to Practice Model (Figure
1) is inclusive of all health care settings that hire
newly graduated nurses and it pertains to all
May, June, July 2009                                                                                                                         DNA Reporter • Page 5

  Delaware Tech Owens to have Accreditation Visit October 2009
    Delaware Technical and Community College, Owens            The Mission and Administrative Capacity Standard         competencies; the inclusion of clearly articulated
Campus will have their re-accreditation visit from the      has nine criteria covering issues such as mission,          student learning and program outcomes; the
National League for Nursing Accrediting Commission          philosophy,      program      outcomes,   communities       curriculum’s rigor and currency; the inclusion
(NLNAC) October 13-15, 2009. This will be their third       of interest involvement, partnerships, faculty              of cultural, ethnic and socially diverse concepts;
visit, having earned their initial accreditation in 1996.   and students involvement in the department/                 the evaluation methodologies used; the length of
With each accreditation/re-accreditation, the program       college; qualifications and authority of the nursing        the program; and the appropriateness of clinical
has written to revised NLNAC Standards and Criteria;        administrator; integrity of policies, and the               experiences to the accomplishment of student
this time is no exception.                                  mechanism by which complaints/grievances are                learning outcomes. This standard also requires that
    The NLNAC released the 2008 edition of their            handled and resolved.                                       programs demonstrate the use of educational theory,
Standards and Criteria in February 2008. This edition          The Faculty and Staff Standard also has nine             interdisciplinary collaboration, research, and best
was substantially different from the 2006 edition.          criteria that examine credentialing for both full and       practice standards. Clinical experiences must reflect
Those programs being accredited/re-accredited in the        part-time faculty/staff; adequacy in terms of numbers       current best practices and nationally established
fall 2009 are the first to utilize the new Standards.       of faculty/staff; orientation and mentoring; evaluation     patient health and safety goals.
A description of the new standards will follow a brief      of faculty/staff performance, and faculty scholarship.         The Resources Standard has three criteria that
overview of the purpose of and processes surrounding        A new aspect of one criteria in this standard is the        assess the fiscal, physical, learning, and technology
accreditation.                                              requirement that faculty must demonstrate evidence-         resources available to faculty and students. These
    To quote from the 2008 Edition of the Accreditation     based teaching and clinical practices. Owens Nursing        resources are assessed in terms of their adequacy for
Manual: “The purpose of the NLNAC is to provide             Department was fortunate to have one of our faculty         the completion of program goals.
specialized accreditation for programs of nursing           members, Karen Watts, attend the 2008 Summer                   The final standard, Outcomes, has six criteria
education, both postsecondary and higher degree,            Institute on Evidence-Based Practice: Innovation            that require the measuring and reporting of program
which offer either a certificate, a diploma, or a           for Quality and Safety in San Antonio. As part of           outcomes in the areas of NCLEX-RN passage rate,
recognized professional degree (clinical doctorate,         this institute, Ms. Watts was invited to participate        program completion rate, program satisfaction and
master’s, baccalaureate, associate, diploma, and            in the national consensus-forming expert panel and          job placement rate. Also in this standard is the
practical)” (p. 1). The NLNAC currently accredits over      invitational roundtable whose goal was to define            requirement for programs to have a comprehensive
1200 programs. As the sole accrediting agency for           essential evidence-based practice (EBP) competencies        systematic plan for evaluation of each of the NLNAC
associate degree, diploma, and practical nursing            to be incorporated into associate degree education.         standards as well as the student learning and
programs, the NLNAC conducted 120 program                   EBP competencies already exist for baccalaureate,           program outcomes. The program must demonstrate
evaluation visits to these three program types in           masters, and doctoral education and these were used         that the results of their systematic evaluation plan
2007-2008 with 119 visits scheduled for 2008-2009           as a basis for the development of the associate degree      are used to make decisions, to maintain or improve
(NLNAC website). All three campuses of Delaware             EBP competencies. The associate degree education            student learning outcomes, and that the results are
Tech, University of Delaware, Delaware State                EBP competencies are expected to be published               shared with communities of interest.
University, Wesley College, Beebe School of Nursing,        in 2009. These competencies will help guide the                The Owens Campus faculty are busy preparing
and Wilmington University currently hold full               incorporation of EBP into our curriculum. Mrs. Watts        the final draft of their 200-page self study report
accreditation from the NLNAC. Wilmington University         has also provided educational programs for the Owens        in response to the 2008 NLNAC Standards. It is an
is also accredited by the Commission on Collegiate          nursing faculty to learn about the basic tenets of EBP.     exhaustive process but one that is affording us the
Nursing Education (CCNE).                                      The Students Standard has seven criteria that            ability to learn from one another and to work together
    Accreditation site visits are conducted by program      encompass policies, student services, student record-       to improve our program.
evaluators, volunteers from education and service who       keeping, the integrity and consistency of information          Submitted by: Tamala Dykes Paxton, Owens
conduct the three to five day visits as peer reviewers      provided to the public; how changes in policies             Campus Department Chair/Instructional Director
to verify, clarify, and amplify the information             are communicated; how students are oriented to
contained in the school’s self study report. Currently,     and supported in their use of technology; and the           References
there are nine Delaware program evaluators from             campus’ compliance with the Higher Education                   National League for Nursing Accrediting Commission,
educational programs at the associate, baccalaureate,       Reauthorization Act Title IV which guides financial         Inc. (2008) NLNAC Accreditation Manual (2008 Edition). New
                                                                                                                        York: Author.
and master’s levels (NLNAC website). Three of these         aid.
                                                                                                                           Watts, K. (2008). Teaching nursing faculty concerning
program evaluators are from the Owens Campus:                  The Curriculum Standard has eight criteria               using evidence-based practice in associate degree nursing
Jennifer Akey, Sally Danz and Tammy Paxton.                 covering all aspects of curriculum such as the              education. (Masters Capstone project, Wilmington University,
    The 2008 Standards for all educational program          inclusion of professional standards, guidelines and         2008).
types address the entire program and are the
following:

                                                                  Professional Development Committee
   • Mission and Administrative Capacity
   • Faculty and Staff
   • Students
   • Curriculum
   • Resources                                                 Karen A. Carmody, MSN, FNP-BC, RN; Chair                 (b) Determination of educational objectives; (c) Selection
   • Outcomes.                                                                                                          and presentation of content; (d) Selection of all persons
    The specific criteria for each standard vary by            Congratulations!        The     American      Nurses     and organizations that will be in a position to control
program type. There is also a specific criterion for        Credentialing Center’s Commission on Accreditation          the content of the CE; (e) Selection of educational
each standard, regardless of program type, that             has granted accreditation to the Delaware Nurses            methods; (f) Evaluation of the activity. A commercial
addresses distance education. This article will             Association Provider Unit for another FOUR years.           interest cannot take the role of non-accredited partner
summarize the criteria for associate degree education,      Our thanks go out to those Professional Development         in a joint sponsorship relationship”. Accordingly, the
the program type for initial preparation for the            Committee members who worked on that application to         Delaware Nurses Association is unable to ensure that
majority of registered nurses nationwide.                   make this award possible.                                   the program funded by the pharmaceutical company
                                                               It takes a concerted effort to keep the DNA              is a bona fide educational program and that the
                                                            continuing education programs affordable, available         financial support is not an inducement to prescribe
                                                            and of interest to all Delaware nurses. This year is no     or recommend a particular medication or course of

    Upcoming Events                                         exception. The committee has been meeting regularly
                                                            to flush out programs for members and non-members,
                                                                                                                        treatment. However, the Advanced Practice Nurses still
                                                                                                                        desire to have the latest, most accurate information
                                                            students and advanced practice nurses. The spring of        available regarding prescription medicines, which play
  Cultural Competency Series                                2009 will bring the first combined DNA/APN program          an ever-increasing role in patient healthcare. Therefore,
  May 7, 2009                                               to the University of Delaware’s Clayton Hall on April 30,   they continue to meet monthly for a pharmacology
    Cultural Competence in Health and                       2009. Rebecca Patton, ANA President, will return once       lecture and networking.
    Social Services                                         more to Delaware to visit hospitals and educational            If you have a special interest in nurses’ continuing
    FREE for DNA/DAFP/NMA Members                           facilities, before giving the keynote at the conference.    education, please consider volunteering to work with
  May 19, 2009                                              Mark your calendars and sign up early. Seating is           the planning committee to implement these and other
    Creating a Culturally Sensitive                         limited.                                                    Professional Development programs for Delaware
    Health Care Environment                                    Other PDC activities include partnerships with the       nurses. We have lots of fun and any registration fee is
    FREE for DNA/DAFP/NMA Members                           Delaware Division of Public Health and the Delaware         reduced for all active committee members. Contact the
                                                            Academy of Family Physicians to bring a series of           DNA office at 302-998-3141.
  June 13, 2009                                             Cultural Competency Workshops to healthcare providers
    The Role of Primary Care Provider in HIV Care           across the state from March through May 2009–FREE
    St. Francis Hospital, Wilmington
  Medicine Take Back Event
                                                            for DNA Members. Don’t miss the Environmental
                                                            Conference “Shaping Our Legacy, Women’s Health and
                                                                                                                        January-February 2009
    Date: June 1, 2009
    Location: Bayhealth Medical Center
                                                            the Environment” Thursday, April 9, 2009 1:00pm-
                                                            5:00pm at Christiana Care Hospital–also FREE for             Approved Providers
                                                                                                                            and Programs
  Nurse Excellence Awards Banquet                           DNA Members. Look for smaller low cost or FREE
    July 16, 2009                                           CE events throughout the year on topics such as the
    Modern Maturity Center                                  Primary Care Provider’s Role in HIV Care, Women and
    Visit www.denurses.org to download Nurse                Health Disease, Pain Management across the Spectrum.
                                                               Many Advanced Practice Nurses have asked why               VA Medical Center—Provider
       Excellence application.
                                                            DNA stopped giving contact hours for monthly dinner           DSNA 9th Annual Winter Conference—DSNA
  2009 Fall Conference
                                                            meetings. The ANCC Standards for Commercial                   Our Journey of Hope—Aldersgate Methodist
    October 22, 2009
                                                            Support states that “A CE provider must ensure that             Church
    DTCC-Owen Campus
                                                            the following decisions were made free of the control of      The 20th Annual Update in Cardiology—
    Arts and Science Center Georgetown, DE
                                                            a commercial interest”. (a) Identification of CE needs;         Cardiology Associates
Page 6 • DNA Reporter                                                                                                                          May, June, July 2009

    Delaware Nurses                                         Delaware Excellence in Nurse Practice Awards Application
      Association                                           Please remember to review your application in its entirety, as incomplete applications will not be accepted.
                                                        If you are completing this application electronically, you may use this document as a template for completing

    ANCC Webinars
                                                        the application. Please mark/type where appropriate.

                                                                                   A blind review process will be used for selecting award winners.
                                                                                        Deadline for application submission is June 1, 2009.
   Last month, ANCC has announced the availability
of the new 2009 Accreditation manual. ANCC                              Applications may be emailed to nurseexcellence@denurses.org or via US Mail to:
is planning a series of webinars regarding the                                                  Delaware Nurses Association
changes in the manual and other aspects of the CE                                                 5586 Kirkwood Highway
‘business’.                                                                                        Wilmington, DE 19808
  • These webinars will begin on April 29th at           Note: Applications (.doc or pdf format) may be burned to a CD and mailed to the above address. Please keep
    1:00pm (Eastern).                                    a copy of your nomination for your records. You will receive a confirmation notice. This confirmation notice
                                                             ensures that we’ve received your nomination and no further action will be necessary on your part.
  • There will be five webinars of about 90 minutes
    (each) in length. You may choose to attend each       A. I am nominating ____________________________________________ for the category of:
    one or only those that are of interest to you.
                                                                     Acute Care-Hospital based                    Advanced Practice Nurse
  • The webinars will be presented by MaryMoon                       Long-Term Care-SNF, Hospice                  Nurse Leader/Manager
    Allison, MHSE, BSN, RN and Pam Dickerson,                        Community-Based Care-Home                    Nurse Educator
    PhD, RN-BC                                                        Care, Office, School                         New Nurse Graduate*
                                                              *A new nurse graduate is classified as an individual who has successful passed the NCLEX exam and has
  • The topics of the webinars are:                        been employed in the nursing field for less than twelve (12) months.
    • April 29th at 1:00pm EDST: Highlights
      of 2009 Criteria (lead speaker: MaryMoon          The candidate is employed by ______________________________________________________ Unit: __________________
      Allison)
    • May 14th at 1:00pm EDST: Forms and Tools          Work Phone: (     )_________________ Home Phone: (        )_________________ Email: _____________________________
      (lead speaker: Pam Dickerson)
    • May 28th at 1:00pm EDST: Monitoring               Home Address:
      Processes/Activities (lead speaker: MaryMoon      Street: ______________________________________ City: _____________________ State________ Zip Code:____________
      Allison)
    • June 10th at 1:00pm EDST: Retaining CE               Provide a brief paragraph under each statement. Your responses should be carefully written and include
      Business (lead speaker: Pam Dickerson)            elements of the scoring criteria listed below.
    • June 25th at 1:00pm EDST: Use of                     B. State in your own words how this candidate exhibits Excellence in Nursing. Please do not refer to the
      Volunteers in Approver Units (lead speaker:             nominee or their employer by name in this portion of the nomination.
      Pam Dickerson)                                       C. Tell us about a specific situation where this candidate has gone above and beyond in his/her area of
                                                              work. Please do not refer to the nominee or their employer by name in this portion of the nomination.
  • Registrants for each webinar will receive, via         D. If submitting for the Nurse Educator category, please address one of the following. Please do not refer to
    email, the power point slides for the session for         the nominee or their employer by name in this portion of the nomination.
    which registered. At this time, the registrant            • Explain how the nurse educator participated in patient assessment through the development of
    will also receive the telephone number and                    screening tools, research projects or epidemiological studies.
    passcode to use for the webinar.                          • Describe the nominee’s scholarly activities: this may include the conduct and dissemination of
                                                                  research; presentations at local and regional conferences; or integration and synthesis of past
  • The didactic portion of the presentation will                 research.
    be provided telephonically. Please plan to have           • Describe how the nominee has assessed learning needs of groups or individuals, developed and
    computer access at the time you participate                   implemented programs and provided outcome analysis based on established Educational Design
    in the webinar. Use of cell phones for                        Criteria.
    participation in the webinar is prohibited.
                                                           E. Identify other professional qualities that the candidate has shown in his/her profession (check all that
  • The didactic portion of the webinar will be               apply).
    recorded. It will be accessible for at least 60            Leadership activities
    days following the webinar. To receive the power           Participation in research activities
    point slides and to access the recording, you              Membership in professional organizations
    must contact the ANCC Accreditation Program                Involvement in continuing education activities, such as presenting lectures and publishing
    for the needed information (Slides, telephone              Community service or volunteer activities
    number and passcode to use)                                Other ______________________________________________________________________________________________
                                                           Please attach any additional information to support each quality selected with comments, awards, media
  • There is no cost for these webinars. There is       items, and noteworthy events that you would like the selection committee to consider.
    no limit to the number of individuals that may
    ‘listen in’ to the webinar.                           F. Your Information

   Please help to ensure these webinars address           Name: __________________________________________________________________________________________________
your questions and concerns. Share your questions/
concerns with by April 14th so that appropriate           Employed by _________________________________________________________________ Unit: ____________________
information can incorporate into the presentation.
Send comments to sarah@denurses.org.                      Work Phone: (       ) ________________________ Email: ______________________________________________________
   If you plan to participate, please send your name,
phone number and email information along with the                                              Thank you for your nomination.
session(s) you plan to attend to sarah@denurses.org                     Please visit www.denurses.org for the time and location of the awards ceremony.
by April 28, 2009.
   Anyone that applies to the DNA for program/                                                             Scoring Criteria
provider approvals or are responsible for continuing
nurse education at their organization are strongly      Nurse Leader                              Long-Term Care                          Advance Practice
encouraged to participate.                              Environment for Practice    25 points     Clinical Practice         40   points   Environment for Practice    40   points
                                                        Leadership                  25 points     Management                25   points   Leadership                  20   points
                                                        Health Policy               15 points     Advocacy                  10   points   Health Policy               20   points
                                                        Scope of Influence          10 points     Professional Qualities    20   points   Scope of Influence          15   points
                                                        General Comments              5points     General Comments           5   points   General Comments             5   points
                                                                                   100 points                              100   points                              100   points

                                                        Acute Care                                Nurse Educator                          New Nurse Graduate
                                                        Clinical Practice           40   points   Education                35 points      Clinical Practice           35   points
                                                        Management                  25   points   Health/Academic                         Management                  15   points
                                                        Advocacy                    10   points   Counseling                10   points   Advocacy                    15   points
                                                        Professional Qualities      20   points   Scholarship               35   points   Professional Qualities      30   points
                                                        General Comments             5   points   Scope of Influence        10   points   General Comments             5   points
                                                                                   100   points   General Comments          10   points                              100   points
                                                                                                                           100   points
                                                        Community-Based Care
                                                        Clinical Practice       40       points
                                                        Management              25       points
                                                        Advocacy                10       points
                                                        Professional Qualities  20       points
                                                        General Comments         5       points
                                                                               100       points
May, June, July 2009                                                                                                                 DNA Reporter • Page 7


 Key Legislative Issues to Watch
                Ann Darwicki R.N.                        Health and Social Services, CLASI is authorized          that would be lost due to the absence of premium
                                                         to solicit and investigate reports of abuse, neglect,    payments. Removing the premium payment may
                                                         mistreatment and fi nancial exploitation in covered      reverse declining enrollment in the Program and

State Level                                              facilities. Finally, the Bill deters interference and
                                                         retaliation against persons cooperating with such
                                                                                                                  increase the number of children in Delaware who
                                                                                                                  have health insurance coverage.
                                                         investigations.
       House of Representatives                                                                                   Senate Bill #17
                                                                                                                    This Bill creates a statewide health insurance
                                                         House Bill #34
House Bill #75                                              This Bill creates a committee to assess deaths        purchasing pool to allow individuals and small
   This Bill allows each competent adult patient         of individuals receiving residential mental health       businesses to obtain the most favorable premiums
to receive visits in a Hospital, nursing home or         services through the Division of Substance Abuse         possible from the private insurance market.
nursing facility from any individual from whom the       and Mental Health or funded private providers.
patient desires to receive visits, subject to certain       The purpose of the Committee is to assess
                                                         causation; promote improvements in policies,
                                                                                                                              Federal Level
restrictions set forth in a visitation policy related
to the patient’s medical condition, the number of        practices, and the service delivery system; and                 House of Representatives
visitors simultaneously permitted in a patient’s         reduce prospects for preventable deaths.
room, and visitation hours and/or order of a Court.                                                               H. R. 448
In addition, this Bill requires the Hospital, nursing    House Concurrent Resolution #2                              To protect seniors in the United States from
home or facility to honor advance health-care              This Concurrent Resolution urges Congress              elder abuse by establishing specialized elder abuse
directives and any similar documents, subject to         and the President of the United States to enact the      prosecution and research programs and activities
certain limitations set forth in the Bill.               National Health Insurance Act. The Resolution to be      to aid victims of elder abuse, to provide training to
                                                         provided to the Delaware Congressional delegation        prosecutors and other law enforcement related to
House Bill #69                                           and the President of the United States.                  elder abuse prevention and protection, to establish
   This Bill establishes a career training program for                                                            programs that provide for emergency crisis response
direct care staff providing long-term care services                Environmental Issues                           teams to combat elder abuse, and for other purposes.
to enhance consumer care and satisfaction with
improved employee training and retention. This Bill      House Bill #24                                           H. R. 1086
is modeled after a similar act in Pennsylvania.             The purpose of this legislation is to ensure             To improve patient access to health care services
                                                         that all hazardous waste generated in this State is      and provide improved medical care by reducing the
House Bill #64                                           treated, stored, or disposed of in a safe manner that    excessive burden the liability system places on the
  This bill enables small businesses in the State,       is protective of public health and the environment,      health care delivery system.
such as school bus contracting businesses, to            and according to all existing and future federal
participate in the State Group Health Insurance          standards. The legislation is also designed to prevent                        Senate
Program at no cost to the State, effective July 1,       hazardous waste generated in this State from being
                                                                                                                                     S. CON. RES. 6
2009.                                                    sent outside of the United States to countries where
                                                                                                                     Expressing the sense of Congress that national
                                                         health and environmental standards may not be
                                                                                                                  health care reform should ensure that the health
House Bill #44 w/HA 1                                    equal to standards in this country.
                                                                                                                  care needs of women and of all individuals in the
   This Act authorizes the State Fire Prevention
                                                                                                                  United States are met.
Commission to incorporate a non-profit, non-             House Bill #70
                                                                                                                                           S. 4
stock corporation for the purpose of establishing,          This Bill bans the use of covenants or other
                                                                                                                     To guarantee affordable, quality health coverage
administering and operating an overnight camp            restrictions  to   prohibit   the installation of
                                                                                                                  for all Americans, and for other purposes.
devoted to helping young people who have suffered        wind systems in Delaware and sets minimum
severe burns deal with the physical and emotional        requirements for such operations.
                                                                                                                  S.275
issues arising from such injuries. (passed)
                                                                                                                     Children’s      Health     Insurance      Program
House Bill #42
                                                                              Senate                              Reauthorization Act of 2009–Amends title XXI (State
                                                                                                                  Children’s Health Insurance Program) (SCHIP) of the
   This Act creates the Delaware Psychiatric Center      Senate Bill #18                                          Social Security Act (SSA) to reauthorize the program
Authority and removes the Center from the purview           This Act removes the provision that participants      (referred to in this Act as CHIP) through FY2013 at
of the Department of Health and Social Services.         in the Delaware Healthy Children Program pay             increased levels. Passed by Both House and Senate
                                                         a premium to participate, while allowing the
House Bill #41                                           Department of Health and Social Services to              Sources
   As the State mental health delivery system evolves    consider instituting minimal co-payments for health      http://www.house.gov/
from a primarily institutional to a community-based      services in order to recover a portion of the revenue    http://legis.delaware.gov/
model, it is important to defi ne minimum patient
rights in community facilities. This Act establishes a
community mental health treatment act with rights
paralleling those of patients in the substance abuse
treatment system compiled in Chapter 22 of Title 16
of the Delaware Code.

House Bill #39
   Currently statutory anti-retaliation and protective
provisions for patients and others only apply to
licensed long-term care (LTC) facilities. Only part of
the Delaware Psychiatric Center (DPC) is a licensed
LTC facility. This Bill, to protect all patients and
employees at DPC, applies such protections to all the
DPC facilities.

House Bill #38
   This Bill requires mental hospitals and residential
centers covered by the Mental Health Patients’ Bill
of Rights Act to report deaths and critical incidents
to the State Protection & Advocacy Agency which
is authorized by federal law to investigate such
occurrences.

House Bill #37
   This Bill adds various protections to the Mental
Health Patients’ Bill of Rights Act, including
safeguards in administration of restraint and
requirement of an enhanced patient grievance
system for DPC patients.

House Bill #36
   This Bill clarifies the role of the Community
Legal Aid Society, Inc. (CLASI), designated for
the past 30 years as Delaware’s Protection and
Advocacy Agency pursuant to federal law, in
protecting patients and residents in nursing and
similar facilities. As a complement to the existing
protective system operated by the Department of
Page 8 • DNA Reporter                                                                                                                       May, June, July 2009


                      Facing the Challenge of Retention
             Kathy Sokola, MS RN CNE                       this faculty member assists students with math           popular. Some students prefer the smaller groups
                                                           competency and test taking strategies and provides       over larger numbers of students attending SIP-N,
   Nursing programs across the country have                an open atmosphere for students to discuss personal      and other students use both programs as resources
expanded to address the nursing shortage. At the           issues that may impede success. The Retention            to help them be successful. Students relate well
local level, the expansion of the nursing program          Coordinator also has the responsibility for overseeing   to having a peer who has experienced some of the
at the Stanton campus of Delaware Technical &              one of the major initiatives to increase retention –     same frustrations and hurdles providing first hand
Community College (DTCC) has also been driven              the Supplemental Instruction Program in Nursing          guidance. The interns receive monetary assistance
by the demands for more nurses in the health               (SIP-N).                                                 for their participation through DTCC’s Peer Tutoring
care system. With increasing numbers of students              SIP-N was based on the recognition that               Program. The interns work closely with the Retention
entering nursing many, new challenges have faced           many nursing students require reinforcement of           Coordinator and faculty members, who provide
faculty and even greater emphasis has been placed          information to develop the confidence and skills         oversight for the program and resources for the
on one of the most complex challenges for any              needed to successfully complete the clinical nursing     interns.
nursing program. That challenge is retention. Like         courses. Grant funding received from The Good               The goal of retaining students has led to the
all nursing programs, DTCC strives to ensure that          Samaritan, Inc. Foundation in 2005 provided the          development of several support groups to help
as many students as possible remain in the program,        stimulus for this program. Through SIP-N students        students address unique issues and to foster
successfully graduate, and enter the professional          have the opportunity to partake in free supplemental     networking. A Men in Nursing group, led by a male
work force. At Stanton, several initiatives have been      instruction each week. SIP-N sessions are arranged       faculty member who is a former graduate, is an
implemented to assist with attaining this goal. These      by the Retention Coordinator and are taught by           informal group that provides male nursing students
include the development of a retention coordinator         practicing registered nurses, many of whom are           with support and encouragement during their
position, a mechanism for identifying students at          graduates of the program. During these voluntary         pursuit of a nursing career. The group promotes the
risk of failure, the institution of a supplemental         sessions, students bring questions about difficult       positive image of men in nursing, offers academic
instruction program, the creation of a nursing             material, and the instructors facilitate discussion      and employment advice, and works collaboratively
education internship program, and the engagement           around key concepts, helping students manage and         to promote men’s health in the community. An
of students in creative learning strategies that           interpret complex information. The sessions are          LPN Support Group was initiated after LPNs
address a diverse, multi-generational student body         designed to help students develop problem-solving        entering the program through advanced placement
with varied learning styles.                               and critical thinking skills that are necessary to       identified a need for assistance with the transition
   One of the first initiatives to focus on the issue      successfully complete clinical nursing courses and       to the program and to the role of the student. A
of retention was based on the realization that the         that are essential in preparing for NCLEX-RN. To         support group for international students is being
highest attrition rates for nursing students occurred      obtain the most benefit from SIP-N, students are         investigated.
in the first level nursing courses. Our Student Issues     encouraged to attend sessions on a regular basis.           Initiatives to improve retention are also found in
Committee worked to identify factors predictive of         Through frequent participation, students have the        the classroom. Faculty has worked hard to address
student failure and then adapted an algorithm with         opportunity to master class content in a timely          the various learning styles of students. A personal
permission from the works of Vicki Ann McDonald            manner. Students who attend three or more SIP-N          response system has been purchased and will soon
to guide interventions. At-risk students are identified    sessions prior to an exam generally score higher         be implemented to increase engagement of students
by the Instructional Coordinator using established         than those who do not.                                   in the classroom. The Campus Lab Coordinator
criteria as they enter the nursing program. The               In addition to SIP-N, students may seek assistance    has worked diligently to integrate high fidelity
Instructional Coordinator then notifies the faculty        and support from the nursing education intern.           simulation into the curriculum, offering students
advisor who follows the algorithm for making               The Nursing Education Internship program was             a strategy for developing critical thinking and
contacts with the student and selecting appropriate        initially created to address the growing shortage        decision making skills under complex and realistic
actions to assist the student based on the student’s       of nursing faculty by generating an early interest       situations. The Campus Lab Coordinator has made
progress and personal needs. Faculty advisors,             in nursing education as a career choice among            Saturday morning lab hours available with a full
Student Issues Committee, and the Retention                undergraduate students. The goal was to provide          time faculty member in attendance to assist students
Coordinator work collaboratively to monitor the            the opportunity for students to explore the teaching     with skill acquisition. This is very popular with first
progress of these students.                                career while still a student in the nursing program.     semester students and helps with their socialization
   The position of Retention Coordinator was created       However, it serves an additional purpose in the area     into the program. Home Health Care labs, Critical
to provide clinical nursing students with a resource       of retention. Students entering their last semester      Thinking Simulations and the creative integration
person to assist them when they encounter problems         of nursing are eligible to apply for the internship      of technology offer students multiple modalities for
that could affect their ability to successfully complete   position with faculty making the final selection. The    learning according to their individual styles.
the nursing program. The Retention Coordinator             intern mentors and supports students at the earlier         Through all of these efforts, the nursing program
maintains an active database of all students in the        levels through small group sessions that assist with     at DTCC Stanton campus is working to improve
program and collaborates with faculty to monitor           mastery of course content through a structured           the retention of its nursing students. Faculty will
academic and clinical progress. In addition,               tutoring program. This program has been very             continue to seek innovative ways to help students
                                                                                                                    achieve success.
May, June, July 2009                                                                                                                             DNA Reporter • Page 9

              Integrating the Concepts of Safe Patient Handling and
                       Movement into a Nursing Curriculum
             Christine Jarrell, RN, MSN                         In the fall of 2004 an invitation to submit an          of SPHM is a health promotion/injury prevention
                                                            application to participate in a research study              activity for nurses. It continues to be included in this
                                                            titled “Development and evaluation of a safe                course.
     Christine M. Jarrell earned her BSN from               patient handling and movement curriculum” was                  The nursing faculty chose to emphasize the
  the University of Delaware and her MSN from               disseminated to schools of nursing throughout               importance of patient safety and prevention of
  Wesley College. Christine has worked in acute             the United States. This research study was a joint          musculoskeletal injuries in nurses. Thus, SPHM
  care at Bayhealth Medical Center, as a Public             effort between the ANA, the National Institute of           concepts should be interwoven into each level
  Health Nurse for the State of Delaware, and               Occupational Safety and Health, and the Veterans            of the nursing curriculum at Wesley. This is the
  as a manager of the Home Health Care Unit at              Integrated Service Network 8. The faculty of the            current plan: Freshmen receive an introduction to
  Bayhealth Medical Center. She is currently the            Department of Nursing at Wesley College submitted           the concepts of SPHM and hands on instruction in
  Coordinator for Learning Resources at Wesley              an application and Wesley was chosen as one of 26           the safe use of lifting equipment. In the sophomore
  College, Department of Nursing. In this role,             schools nationwide to participate in this research          year, a representative from the Christiana Care’s
  she manages simulation activities and the                 study.                                                      PEEPS program provides a mandatory in-service
  skills competency-testing component of the                    In March 2005, nursing faculty members from the         to students to meet the competency requirements
  BSN program. Christine was the designated                 chosen schools attended the 5th Annual Safe Patient         of clinical affiliation with this agency. The junior
  nursing faculty member from Wesley College to             Handling and Movement Conference in Tampa,                  nursing students have a dedicated skills day each
  attend the Safe Patient Handling and Movement             Florida. They received training during the general          spring. Groups of students are assigned a specific
  Train the Trainer conference in March 2005.               educational sessions and specific training on the           skill which they have already mastered. They are
  She coordinated the nursing department’s role             required activities involved in the research study. In      required to demonstrate and research this skill with
  in the research project to integrate Safe Patient         the spring and summer of 2005, Wesley completed             an emphasis on patient safety, current regulatory or
  Handling and Movement training into the BSN               the IRB approvals and reviewed the Foundations              accreditation standards, risk management issues,
  curriculum. Christine can be reached by email             of Nursing (NR214) course content to allow for              and real world problems related to the actual day to
  at jarrelch@wesley.edu or at her office number            the time needed to include the pre-test, SPHM               day performance of the skill. Safe patient handling
  (302) 736-2497.                                           educational module, and post test. Several lifting          is always one of the skills included. Senior level
                                                            equipment companies offered to participate in this          students also must pass a final skills test and safe
                                                            study and were each assigned to specific schools of         patient handling is included in this test.
    Since 2003, the American Nurses Association             nursing. The companies delivered and installed their           In addition to course work, the students volunteer
(ANA) has been an advocate for the implementation           equipment over the summer.                                  each year to offer a Girl Scout Badge in Nursing to
of safe patient handling work environments for all              In November 2005, students in the NR214 course          brownies, junior, cadets, and senior girl scouts.
nurses. The position statement titled “The elimination      completed the SPHM module. The nursing faculty              One of the popular stations included in the badge
of manual patient handling to prevent work-related          also completed faculty specific pre-tests and post-         workshop involves having the scouts learn to use
musculoskeletal disorders” was approved by the ANA          tests. Students were enthusiastic about learning            the lifting equipment. In November of 2005, Wesley’s
Board of Directors in June 2003.1 Many evidenced            how to use the lifting equipment. One consistent            Tau Beta Chapter of Sigma Theta Tau International
based articles have been published to support               comment in the module evaluation, however, was the          sponsored a conference on Safe Patient Handling
the need for widespread adoption of Safe Patient            disconnect between the principles of SPHM and what          and Movement. Junior and senior students in the
Handling and Movement (SPHM) practices.                     they were encountering as student nurses in the             undergraduate program and students in the graduate
    Safe patient handling is the “application of            “real” world.                                               program participated in this conference.
evidenced based strategies to reduce the risk(s)                A subsequent study, titled “Faculty perceptions            The nursing faculty and students at Wesley College
associated with manual patient handling.”2 These            of implementing an evidence-based safe patient              have not only incorporated the SPHM concepts into
strategies include the use of equipment, such as            handling nursing curriculum module” was completed           the nursing curriculum, but have truly embraced
ceiling lifts, portable lifts, friction reducing devices,   in 2007. In this study, participating nursing faculty       these concepts as a critical part of their nursing
motorized stretchers, etc. as well as the staff             identified two barriers to the inclusion of the SPHM        practice.
education and ongoing support needed to assure that         concepts into a nursing curriculum. One barrier
the equipment is used safely and effectively. Nursing       reported was “...the difficulty of fitting one more thing   References
staff must also be instructed on patient assessment         into an already crowded curriculum.”3 The other               1. American               Nurses             Association–Handle
                                                                                                                             with      Care       Backgrounder:          ANA’s      Advocacy
criteria and the use of decision trees or algorithms to     barrier “was the challenge of working with faculty
                                                                                                                             on       Ergonomics.            Available       at:       http://
choose the appropriate equipment.                           colleagues who did not attend the train the trainer              nu r s i n g w o r l d .o r g / M a i n M e nu C a t e g o r i e s/
    In the state of Delaware, acute care hospitals          program and insisted on keeping the paradigm of                  Occupat iona la ndEnv ironmenta l/
vary in the degree of formal integration of SPHM            relying on body mechanics as the primary means                   occupationalhealthhandlewithcare.aspx.                 Accessed
practices, staff education and equipment. Long term         of preventing injury.”3 These barriers were not                  February 27, 2009.
care facilities have incorporated the use of mobile lift    encountered at Wesley College.                                2. Nelson A, Baptiste A. Evidence-Based Practices for
equipment in their facilities for several years.                At the end of the 2005-2006 school year, the                 Safe Patient Handling and Movement. 2004 Online
    As recently as 2004, schools of nursing were still      Wesley nursing faculty discussed the appropriate                 Journal of Issues in Nursing. Article published
                                                                                                                             September 30, 2004.
teaching proper body mechanics as the safe way to           placement of the SPHM concepts in the nursing
                                                                                                                          3. Powell-Cope G, Hughes N, Sedlak P, & Nelson A.
lift, move and transport patients, even though the          curriculum and decided that a better fit would be                (2008). Faculty perceptions of implementing an
nursing profession ranked high as an occupation             to include this topic in the Health Assessment and               evidence-based safe patient nursing curriculum
with work related musculoskeletal disorders.3               Health Promotion (NR109) course, since the focus                 module. OJIN: The Online Journal of Issues in
                                                                                                                             Nursing. Article published August 18, 2008.
Page 10 • DNA Reporter                                                                                                                    May, June, July 2009

        Mentoring: The Continuation of Professional Development
        Michelle L. Collins, MSN, RN, BC                their deeper sense of professionalism and mentees         intent of the new program is to facilitate the GN
                                                        reported less social stress during their fi rst year of   transition to practice after completion of orientation,
                                                        employment.                                               foster the professional development of novice RNs,
     Michelle L. Collins                                   Wagner and Seymour (2007) indicated that               and support RNs experiencing a role transition.
  earned her BSN and                                    “when guided by a caring framework of trust,              The team developed a short mentor profi le for each
  MSN from the University                               commitment,       compassion,      and    competence,     volunteer to complete. The minimum criteria include
  of Delaware. She is board                             mentoring [is] a caring action [that] builds healthy      a minimum of one year RN experience at CCHS,
  certified   in    Nursing                             relationships and energizes environments” (p. 201).       exhibiting specific values, being a respected team
  Professional Development                              The authors described how Emerson Hospital,               member, being flexible and reliable, and having
  and has worked as a                                   Fitchburg State College, and Middlesex Community          been a preceptor of students and/or newly hired
  nursing educator for over                             College collaborated to provide a student nurse to        nurses within the past 2 years. Applicants must be
  10 years. She is currently                            RN mentoring program supported by the Nursing             willing to commit to mentoring another nurse for a
  the Nursing Orientation                               Career Ladder Initiative federal grant. The program’s     minimum of 12 months. Nursing staff development
  Coordinator at Christiana                             goal was to improve the success rate of students          specialists and nurse managers review each of the
  Care     Health    System                             at risk of failing through the influence of seasoned      RN applicants to determine eligibility.
  and works with nursing
                               Michelle Collins         direct care nurses. It was marketed to the hospital’s        Mentees will be paired with their unit-based
  educators through out                                 nursing leadership team and its nursing councils.         mentors through individual selection using the CCHS
  the organization to provide quality educational       The program consisted of a workshop, mentoring            nurse mentoring website. Mentors will participate
  content and programming for nurses. She is also       activities for the student-nurse pairs, and monthly       in a four-hour interactive education session they
  responsible for the oversight of all nursing and      group meetings. Voluntary mentor applications             receive before initial mentee contact. Mentor-mentee
  paramedic student clinical experiences within         were circulated by the hospital’s nurse managers;         pairs are expected to set developmental goals and
  Christiana Care. Michelle can be reached by           however, no professional criteria for acceptance were     meet once per quarter minimally. Mentor-mentee
  email at mcollins@christianacare.org.                 denoted by the authors. Selected mentors received         activities are based on short term objectives to meet
                                                        an unspecified stipend and paid workshop time.            the mentee-identified developmental goals. These
                                                        The college and hospital coordinators matched             activities will be tracked over the course of the
   The retention of graduate nurses (GNs) is crucial    the mentor-mentee pairs based on their profi le           program.
to hospitals’ survival as nursing workforce demands     forms which indicated their personal interests               A thorough understanding of the mentoring
increase and retirement of the baby boomer nursing      and experience level. Each pair was required to           process is essential for implementing a successful
workforce looms (Altier & Krsek, 2006). Specialized     have monthly personal contact and electronic or           mentoring program. Successful mentors display
internships or residency programs that extend the       telephone contact weekly. These communications            patience, enthusiasm, knowledge, and respect
length of GN orientation and provide for additional     were documented on a tracking tool that calculated        while successful mentee characteristics include
educational classes are important retention tools.      the time spent and the status of the mentor-mentee        openness to constructive feedback, a strong career
However, mentoring is a more universal retention        relationship. Eleven of fi fteen students successfully    commitment, and personal drive (Kanaskie, 2006).
tool as healthcare agencies that provide mentoring      completed the one year program.                           Effective mentors can be the professional impetus
can potentially influence every nurse’s professional       Latham, Hogan, and Ringl (2008) described              that many nurses need to continue their professional
development as well as every GN’s transition to         a three year relationship between one academic            development in assuming advanced roles in nursing
nursing practice. Parse (2002) described mentoring      institution and two non-affi liated hospitals. The        practice, education, administration, or research.
as “a moment-to-moment process that arises… when        partnership focused on improving the nurse                Higher job satisfaction, personal and professional
two or more presences engage in a dialogue about        workforce environment through development of              growth, and improved socialization to hospital
a scholarly opportunity or a career choice” (p. 97).    a mentoring program which was not specifically            culture are some of the many benefits of mentoring
Both of these defi nitions rely on nurses willingly     geared towards GNs. A steering committee identified       (Dyer, 2008).
supporting each other with long-term measurable         the criteria for mentor and mentee applications and
outcomes in mind.                                       created a website for monitoring the mentor-mentee           References
   Hurst and Koplin-Baucum (2003) described the         teams which also contained a discussion forum,               Altier, ME, & Krsek, CA. Effects of a 1-year
mentoring program at Banner Good Samaritan              personal web pages, and mentoring newsletters.            residency program on job satisfaction and retention
Medical Center as an 18-month support system            Two eight-hour education sessions were provided           of new graduate nurses. JNS. 2006;22: 70-77.
for new registered nurses (RNs). A mentor was           to: emphasize mentoring as a minimum one year                Dyer L. The continuing need for mentors in
selected by the new RN upon completion of the three     commitment for the mentor and mentee, practice            nursing. JNS. 2008;24: 86-90
month precepted orientation. Mentors attended           interpersonal skills, select pairs through review            Hurst S & Koplin-Baucum S. Role acquisition,
a six hour workshop during which the phases of          of personal web pages, review the partnership             socialization, and retention. JNSD. 2003;19: 176-180.
the mentor relationship, program tools, and an          agreement, and develop mutual mentor-mentee                  Kanaskie ML. (2006). Mentoring: A staff retention
overview on dealing with difficult situations were      goals. Mentors were provided paid class time with         tool. Critical Care Nursing Quarterly. 2006;29: 248-
provided. Mentees were aided in their professional      continuing education credits and they were invited        252.
development by their mentors through facilitation of    to a two-hour nursing leadership meeting quarterly           Latham CL, Hogan M, & Ringl K. Nurses
decision-making, role modeling behavior, evaluation     to share their concerns and recommendations for the       supporting nurses: Creating a mentoring program for
of   strengths,    identification  of   improvement     program. A total of 92 pairs completed the program        staff nurses to improve the workforce environment.
opportunities, and participation in professional        over the three years of the project. Program mentors      Nursing Administration Quarterly. 2008; 32: 27-39.
organizations. A database maintained by the program     were successful in supporting their fellow nurses and        McKinley MG. Mentoring matters: Creating,
coordinator recorded the contact information for each   also improved the work environment as a secondary         connecting, empowering. AACN Clinical Issues. 2004;
participant and tracked the evaluation dates of each    benefit.                                                  15: 205-214.
pair at each six-month program interval. The authors       Christiana Care Health System (CCHS) has                  Parse, RR. Mentoring moments. Nursing Science
did not denote the total number of participants,        recently revitalized its RN mentoring program as          Quarterly. 2002; 15: 97.
the mentor selection process, or whether a mentor       another means of advancing our professional nurse            Wagner, AL, & Seymour, ME. A model of caring
may be paired with more than one new RN. They           development. A team of nursing educators formed           mentorship for nursing. JNSD. 2007; 23: 201-211.
indicated a 3.1% reduction in nurse turnover after      in Fall 2008 to reconstruct a nurse mentoring
one year. Anecdotal feedback from mentors revealed      program that was initially introduced in 2004. The




                Visit us on the web
                     anytime at
           www.denurses.org
May, June, July 2009                                                                                                                      DNA Reporter • Page 11

  Implementing Standardized Colors for Patient Alert Wristbands
         Kate Salvato, MSN, RN, NEA-BC                         As with many national initiatives, the call for         alert wristbands as a patient safety initiative
                                                            standardization of colored wristbands has its              may fi nd the following process useful. Begin by
                                                            detracters. The Patient Safety Advisory argued that        defi ning your facility’s location in comparison to
      Kate (Catherine) Salvato                              the use of color-coded patient wristbands created          your peer organizations. Does your facility share
  ea r ned her nursi ng                                     unnecessary risk. When wristbands are used to              borders with several states? Facilities that reside
  diploma from T homas                                      convey medical information errors commonly occur.          in close proximity should consider if their patient
  Jefferson University, School                              Clinicians may not notice wristbands and may               population is likely to transfer between Delaware,
  of Nursing. After competing                               provide treatment inconsistent with the patient’s          New Jersey, Pennsylvania, or Maryland as your care
  her BSN and MSN from                                      condition or preferences. Additionally, wristbands         delivery processes might benefit from this safety
  the University of Delaware                                may be temporarily removed during medical                  initiative. Next, consider the position statements and
  she specialized in Nursing                                procedures and not be replaced. Wristbands may be          recommendations from the national associations that
  Education and Nursing                                     applied in error such as in Pennsylvania’s landmark        govern your practice. The American Organization
  Administration. She is a                                  case. Suggestions made to minimize error, should           of Nurses Executives (AONE), a subsidiary of the
  board certified Advanced                                  colored-wristbands be adopted by a health care             American Hospital Association (AHA), affi rms that
  Nurse Administrator with                                  facility, include:3                                        America’s hospitals are committed to delivering
  over 32 years of nursing
                                  Kate Salvato                 • Limit the number of colors in use on patient          safe care. As the national advocate for America’s
  e x per ience. Cu r rent ly,                                    wristbands.                                          hospitals, the AHA is asking all hospitals to consider
  the Director of Education at Bayhealth Medical               • Standardize the meanings of specific colors           using three standardized colors for patient alert
  Center she is responsible for Staff, Patient and                among health care facilities.                        wristbands. The colors, which have been adopted as
  Consumer Education. Kate can be reached by                   • Use only primary and secondary colors                 a consensus in numerous states are: red for patient
  email at catherine_salvato@bayhealth.org or at               • Use brief, pre-printed descriptive text on the        allergies; yellow for risk to fall; and purple for do-not-
  her office at (302) 744-7188.                                   wristband to provide clarification to clinicians.    resuscitate patient preferences.1
                                                               • Emboss or pre-print text. Handwriting                    The AHA also reminds hospitals that the colored
                                                                  on wristbands should only be done in an              wristband is an alert and the patient status should
   Standardizing the colors for patient alert                     emergency.                                           always be verified with information from the
wristbands has improved patient safety in health               • If your facility uses wristbands for pediatric        patient’s chart. Communication with the patient
care facilities. In 2005, the Pennsylvania Patient                patients that relate to the Broselow color-          and the patient’s family is critical for the success
Safety Authority (PPSA) issued a patient safety                   coding system for pediatric resuscitation carts,     of your safety initiative. Designated staff should be
advisory that received national attention. A near-                consider the potential for confusion between         involved in the process to explain the importance
miss incident occurred in a Pennsylvania hospital                 the Broselow bands, most likely used in the          and meaning behind the standard colors for patient
when a nurse mistakenly placed a wrong colored                    Emergency Departments, Pediatrics, and               alert wristbands. The importance of a nurse who can
wristband on a patient. The nurse applied a yellow                Neonatal Intensive Care, and the other colored-      act as the teacher and discuss the risk associated
wristband with the intent to identify the patient’s               wristbands your facility uses.                       with the patient’s wearing of social-cause bracelets
“restricted limb”. Unfortunately, in this hospital,            • Explain to the patient and/or families the            while an inpatient cannot be minimized. Finally,
a yellow wristband indicated a do not resuscitate                 purpose of all wristbands. This provides an          the organization must be willing to commit both
(DNR) order. In a nearby hospital, where the nurse                opportunity for errors to be identified. This        time and fiscal support for the education of all
also worked, a yellow wristband was intended                      also reinforces the facilities commitment to         employees who participate in patient care activities.
to identify a “restricted limb”.1 Four months                     promoting a culture of safety by encouraging         This includes the Environmental Service worker who
later, a hospitalized patient with a known prior                  patients and their families to participate in        spies a yellow wristband and understands that this
anaphylaxis due to a latex allergy was provided with              efforts to prevent errors.                           patient is at risk to fall or the anaphylaxis reaction
a green wristband—a warning sign for latex allergy.            • Ask patients to remove the social-cause               that is averted because the technician participating
During his hospital stay he was transferred to an                 bracelets that are popular today by explaining       in a procedure has identified the green wristband
ambulatory diagnostic center for a test. The staff at             the confusion to staff and unsafe situations for     and knows to provide a latex free environment for
the center was not familiar with the significance of              patients who refuse to remove the social-cause       this patient.
the green bracelet and the warning of latex allergy.              bracelet.
The procedure was conducted with latex gloves and              • Staff should periodically reconfi rm with the         References:
the patient experienced an anaphylactic reaction                  patient and family the meaning of the colored           Feldpush B. Implementing standardized colors for
that required medical intervention to correct the life-           wristbands and the goal for creating a safe          patient alert wristbands. American Hospital Association.
                                                                  patient environment.                                 2008; 1-4.
threatening situation.4 Although no lasting harm
                                                                                                                          ECRI, ISMP. Use of color-coded patient wristbands
occurred to these patients, the near-misses became             • Consider making wristband verification part of
                                                                                                                       creates unnecessary risk. P. 2005;2:1-4.
the hallmark events which led to a survey revealing               the nursing assessment during shift change.             FDA. Important new information–dangerous confusion
a wide variation in colors and meanings in a group             • Write clear and concise policies and procedures       with color coded wristbands. FDA patient safety news.
of hospitals. Suddenly, the opportunity to improve                that outline who has the responsibility and          2006; 7-8
patient safety became palpable and the need for                   authority to place and remove all wristbands on         Ray L. Use of colored wristbands from hospital patients
action obvious.1,6                                                patients and that all staff have a role in making    in Oregon. Oregon pt safety commission. 2006; 1-5
   After the PPSA announced the near-miss incident,               sure any errors or omissions are quickly                Wristband color standardization. Colorado Foundation
                                                                  corrected.                                           for Medical Care. AHRQ. Identification of inpatient dnr
the dangerous consequences due to the lack of
                                                                                                                       status” a safety hazard begging for standardization.
standardization were exposed. Numerous hospitals               Of course, these statements can be viewed as
                                                                                                                          Hampton K. Standardizing colored wristbands improves
and ambulatory surgery centers in several states            barriers as to why you should beware of moving             patient safety. Strategies for Nurse Managers. Feb 2008.
began to assess the obvious confusion created when          forward with this safety initiative. However, they
colors were not consistent among the healthcare             could also be interpreted as pitfalls to avoid when
facilities. The states which participated in this initial   your facility decides to implement the standardized
assessment process included Colorado, Missouri,             colors for patient alert wristbands.
Arizona, New Mexico, California, Nevada, Oregon,               Healthcare       facilities    contemplating      the
Utah and Oklahoma.2, 5                                      implementation of standardized colors for patient




     Call for Nominations for Elective Office
          2009 Elected Offices Available
 Position                                               Term

 President-Elect/ ANA Delegate                          Four-year commitment—one year as President-
                                                        Elect followed by two years as President and one year
                                                        as Past-President.

 Three (3) ANA Delegates, one                           Two-year term
 from each county.

 Secretary                                              Two-year term

 Three (3) members of the Committee                     Two-year term
 on Nominations, one from each county.


  To self-nominate or nominate a colleague, visit the DNA website: www.denurses.org, click on “about” tab for
consent to run form and information on each of the positions.
Page 12 • DNA Reporter                                                                                                                           May, June, July 2009

                  Nurse Educator: Clearly an Advanced Practice Role
           Lucille C. Gambardella, PhD,                     a mark of professionalism and establishes nursing           high technology skills and high drama are popular
              RN, CS, APN-BC, CNE                           education as a specialty area of practice at the advanced   with those choosing to attend graduate school. Ask
                                                            level (NLN, 2008). It further creates an opportunity for    any nurse educator in practice today and they will tell
                                                            nurse educators to demonstrate their expertise and          you that the classrooms and clinical sites in nursing
                                                            skill in the educator role. (www.NLN.ORG) In fact, the      education at all levels are filled with both! Personally,
      Dr. Lucille Gambardella
                                                            mission of the Academic Nurse Education Certification       this author can tell you that even after thirty-seven
  earned      her     BSN    at
                                                            Program is to recognize excellence in the advanced          years in the classroom, there is seldom a day that
  Villanova University, MSN
                                                            specialty role of the academic nurse educator (NLN,         drama or the need for high technology does not occur
  at Boston University, and
                                                            2008). NLN defines the core competencies required for       and surely any readers who are nurse educators will
  PhD at Columbia Pacific
                                                            achievement in this advanced role and clearly relates       concur.
  University. She is Chair
                                                            these competencies to the theoretical and practical            The nursing profession is in the midst of a perfect
  and full professor at Wesley
                                                            knowledge necessary to achieve the certified status and     storm the affects the future of health care and the
  College and her nursing
                                                            be recognized as an expert in the specialty field.          education of new nurses. This storm, characterized
  career has spanned over 40
                                                               NLN further recognizes the excellence of the nurse       by the nursing shortage in general, the aging of our
  years as a nurse educator
                                                            educator advanced role through its initiative of the        population, the aging of our nursing workforce–
  and clinical specialist in
                                                            Academy of Nursing Education. The fellows chosen for        particularly the nurse educator workforce, the lack of
  psychiatric/mental health
                                                            the Academy are visionary nurse educator leaders who        clinical teaching sites, the wide array of educational
  nursing. Lucille recently              Lucille            have contributed to nursing education in a sustained        choices for the best and brightest of our high school
  completed       service   as      Gambardella             and significant manner (NLN, 2009). The academy             graduates, and the limited number of graduate students
  President of the Delaware
                                                            accepted its third class of fellows this past September.    choosing the nurse educator role are all merging to
  Board of Nursing and is a former vice-president
                                                               The AACN has likewise made significant effort            create a crisis situation. Solutions to this growing crisis
  and president of the Delaware Nurses Association.
                                                            to elevate the status of the nurse educator role.           are not easy, and the best minds in nursing across our
  She is also an accreditation visitor for the National
                                                            Its comprehensive web-based program called the              nation and indeed across the world, have been working
  League for Nursing Accrediting Commission, the
                                                            Education Scholar (www.educationscholar.org) is             toward viable options that will bring about effective
  Middle States Commission on Higher Education,
                                                            an opportunity to advance one’s teaching skills,            outcomes.
  and she is a speaker at professional conferences
                                                            professional scholarship, and improve instructional            In Delaware, the commitment to enhance the
  both nationally and internationally on topics
                                                            capability (AACN, 2008). Modules in the program span        nurse educator role and to contribute to resolving the
  related to nursing education and educational
                                                            topics that include, for example, Facilitating Learning     shortage of nurse faculty is evident in the efforts made
  leadership. Dr. Gambardella can be reached by
                                                            in the Classroom, Problem-based Learning, Learning in       in our institutions; the University of Delaware, Wesley
  e-mail at gambarlu@wesley.edu or at her Wesley
                                                            the Experiential Setting, and Promoting Teaching and        College, and Wilmington University all have programs
  office at (302) 736-2512.
                                                            Learning Excellence in your Institution. (AACN, 2008)       to prepare the graduate level prepared nurse for the
                                                            Similar to the NLN, AACN is committed to the art and        nurse educator role. Options range from a weekend
   The nurse educator role has not always been
                                                            science of teaching and to the advancement of teaching      post-master certificate program to MSN programs with
considered an advanced practice role. It is a relatively
                                                            excellence.                                                 a specialty focus in the nurse educator role. This author
new concept endorsed by both the National League
                                                               In this author’s opinion, recognition of the nurse       would encourage the reader to consider the nurse
for Nursing (NLN) and by the American Association of
                                                            educator as an advanced practice role is a first step in    educator role as an area of advanced practice. The
Colleges of Nursing (AACN). Each of these professional
                                                            the resolution of the nurse faculty shortage. Viewing       top reason that thousands of qualified applicants are
organizations indicates support of this idea in different
                                                            the classroom and clinical learning environments as         turned away from 4 year institutions to study nursing
ways, but the essential element of the scholarly
                                                            practice arenas is a natural process in understanding       is the lack of faculty (62% of schools, responding) to
preparation and recognition of the specialization of the
                                                            the nurse educator role and in recruiting students to       prepare them (AACN, 2009). If the nursing shortage
nurse educator role is clear.
                                                            graduate programs that focus on the leadership and          is to be resolved, the nurse faculty shortage must be
   The NLN began the certification process for nurse
                                                            advanced skills needed for the nurse educator role.         resolved as well. The time has come; the time is now.
educators in 2005. This certification is considered
                                                            At this time, nursing specialties that are laden with       Consider the nurse educator role.



            If Nursing is a Sea of Possibilities, Why Am I Still Adrift?
   Tracy Patrick-Panchelli, BSN, RN-BC, CPN                 understand the bigger picture of my patients’ clinical      2002, I arrived at Nemours/Alfred I. duPont Hospital
                                                            conditions and that I had in fact gained significant        for Children hungry for the opportunity to focus on
                                                            experience. Immersed in an environment of excellence        teaching and took on the role of clinical nurse educator.
     Tracy Patrick-Panchelli is                             in clinical care and very high expectations of its          Earning national certifications in pediatric nursing
  the Coordinator of Nursing                                practitioners, though, I felt challenged. How could I       and in nursing professional development validated my
  Continuing Education at                                   improve myself? Contribute to my unit? And define           increasing knowledge base and elevated my sense of
  Nemours/Alfred I. DuPont                                  success? Certain goals were prescribed and encouraged       professionalism for myself as well as my colleagues.
  Hospital for Children. She                                and ended up being checked off the list over the next       This role allowed me to better understand what nurses
  earned her Bachelor of                                    several years. These included joining a professional        need to prepare for a future of increased information,
  Science in Nursing degree                                 association, earning specialty certification, advancing     increased technology, and increased complexity of care.
  from the University of                                    on the clinical ladder, and developing a professional       It was here that I was first given the opportunity to
  Pennsylvania in 1993 and                                  portfolio. I gained exposure to the coaching-mentoring      attend a national conference and encouraged to present
  her diploma in legal nurse                                role by precepting new nurses and working with              a poster. Expectations of my participation in hospital-
  consulting in 2001. She is                                nursing students. I also enjoyed opportunities to           wide committees soon came. These meetings afforded
  a certified pediatric nurse.                              share my expertise by teaching in nursing orientation,      me the ability to network with colleagues in other
                                  Tracy Patrick-            continuing education programs and certification review      disciplines as well as nurse leaders and to collaborate
  She is also board-certified
                                    Panchelli               courses. Eventually, becoming a team leader gave me         with them to monitor trends in healthcare and their
  in Nursing Professional
  Development and is a                                      a sense of accountability for not only my own practice,     anticipated impacts on nursing care. I soon realized
  frequent lecturer on a variety of nursing practice        but for that of my peers.                                   that my view of nursing as a profession and its integral
  topics.                                                      Having received positive peer and manager feedback       role in the healthcare environment was broadening,
                                                            on my analytical skills, I looked for opportunities         entreating all nurses to be engaged in the process of
                                                            to apply them to income-generating work while               improving care and care systems.
   If what one doesn’t know might hurt them,
                                                            decreasing my hospital work hours in order to care             I have now been a nurse for fifteen years. My
we should all be worried. And so it is with nursing
                                                            for young children at home. Legal nurse consulting          current role as Coordinator of Nursing Continuing
and the need to assimilate rapid, ongoing change.
                                                            seemed a natural fit and I pursued distance education       Education combined with part-time work as a Critical
Fortunately, our profession offers an infinite array
                                                            in this specialty, eventually earning a diploma in          Care Transport Team nurse and my legal consulting
of possibilities to help us both insulate and advance
                                                            2001. Starting my own business was a skill set I did        work demand multiple different skill sets. Unable to
ourselves. All we have to do is seek them out, knowing
                                                            not possess, so I sought out resources everywhere I         latch onto what I really want to be when I “grow up”,
that our skills and knowledge, repeatedly agitated
                                                            could. Ultimately, it was membership in the American        I am choosing to pursue graduate education in order
and combined with others like clothes in a washing
                                                            Association of Legal Nurse Consultants and the              to broaden my horizons and increase the potential
machine, will produce ongoing curiosity, problem-
                                                            Philadelphia Chapter of this organization that proved       for additional career opportunities. But with so many
solving strategies, and an expanded worldview.
                                                            the biggest boon. It was there that I found a network       options available, I had no idea where to start. After
   As a novice nurse in an 800-bed tertiary care
                                                            of collegial, supportive nurses who were willing to         considering different master’s tracks in nursing, I
hospital in New York City, I was struck almost
                                                            share their knowledge, help me get started and provide      ultimately matriculated in Villanova University’s
immediately by a perceived lack of readiness for the
                                                            guidance along the way. Reviewing medical malpractice       Master’s in Nursing—Health Care Administration
job. I was tempted to wonder how my baccalaureate
                                                            cases for defense and plaintiff attorneys and testifying    program. With a broad-based curriculum including
education could have prepared me so poorly as I saw my
                                                            as a nursing expert quickly became my niche and I           courses in health policy and leadership strategies, I
peers who had trained in diploma programs run circles
                                                            have been satisfied with my efforts to grow my business.    am hoping to enhance my ability to create and sustain
around me starting IVs and giving injections. What if
                                                            Ongoing engagement in AALNC led to opportunities to         changes that will benefit nursing practice.
all those hours in the library writing papers couched in
                                                            edit the revised core curriculum, be a peer reviewer for       Nursing education is the foundation for starting in
nursing theory were a waste? Experience and practice, I
                                                            a new legal nurse consulting course, and to get involved    and growing within the profession. In order to develop
soon learned, gave me the confidence with the technical
                                                            with the Philadelphia Chapter Board of Directors.           our careers and also be prepared during uncertain
skills. It wasn’t until years later that the foundation
                                                            Today, as President of the Philadelphia Chapter and a       times, commitment to lifelong learning is essential.
for professionalism and leadership in nursing, set in
                                                            practicing independent legal nurse consultant, I am         Looking for opportunities to diversify one’s skills is
place during my undergraduate education, became
                                                            privileged to be able to contribute to the advancement      another career development strategy. And finally,
recognizable.
                                                            of this specialty and to have a unique perspective on       not being afraid to take risks and volunteer to try
   Two years into my nursing career, I ventured into
                                                            the work of clinical nursing.                               something you’ve never done before can not only teach
pediatric critical care nursing, a newly acquired
                                                               Moving out of clinical nursing for the first time in     valuable skills, but also help to build one’s network of
area of interest. It quickly became apparent that I did
                                                                                                                        professional colleagues.
May, June, July 2009                                                                                                      DNA Reporter • Page 13

                                                    D E L AWA R E        CU LTU R A L        CO M PE TE N CY           E DUCATI O N            S E R I E S

        Delaware
  Cultural Competency
   Education Series
                                                     Purpose                                              are challenged with responding to the
                                                                                                          needs of individuals with culturally
                                                     The population of the United States is               diverse values, beliefs, and behaviors,
                                                     becoming increasingly diverse. By the                a series of workshops will be scheduled
                                                     year 2050, the majority of the nation’s              for the purpose of building a culturally
                                                     residents will be minority. Because                  competent healthcare system in Delaware.
                                                     healthcare organizations and providers



                                                   Goal                                                 Upcoming Session Dates:
                                                      This series of workshops will increase            May 7, 2009—Georgetown
                                                   the cultural competence of health care               (8:00am–10:00am)
                                                   professionals and organizations by raising                     Registration begins at 7:30am
                                                   awareness of cultural issues that impact
                                                   the delivery of health services and providing        Topic: Cultural Competence in Health
                                                   strategies that improve health outcomes.             & Social Services
                                                                                                                Del Tech & Community College
                                                   Learning Objectives                                          (Owens Campus)
                                                                                                                Seashore Highway, Rt. 18,
        Education Series sponsored by:
                                                   At the conclusion of each session,                           Georgetown, DE
                                                   participants will:
   Delaware Division of Public Health
                                                                                                        Speakers:
        in partnership with the                     Understand the central role of cultural                   Horace M. DeLisser, MD,
     Delaware Academy of Family                      competence in the provision of quality                       University of PA
              Physicians                             health care to diverse populations                        Marlene Saunders, DSW, MSW
   and Delaware Nurses Association                                                                                DSU, College of Health & Public
                                                    Learn effective cultural communication                       Policy
                                                     strategies that enhance trust between
                                                     patient and health care provider                   *Continental breakfast served
 The Cultural Competency Education Series is
 being developed by the Delaware Division of        Understand how cultural differences
 Public Health in partnership with the Delaware
                                                     between patient and provider affect the            May 19, 2009—Newark
 Nurses Association and the Delaware Academy of
 Family Physicians.                                  patient-provider relationship                      (8:00am–10:00am)
                                                                                                                  Registration begins at 7:30am
 Supporting Agencies:                               Learn practical methods to address
 Chi Eta Phi Nursing Sorority                        cultural challenges faced when caring for          Topic: Creating a Culturally
 DSU, College of Health and Public Policy
                                                     diverse patients                                   Sensitive Health Care Environment
 Del Tech School of Nursing
 National Social Workers Association, DE Chapter                                                                John Ammon Education Center
                                                   Who Should Attend:                                           Christiana Care Health Systems
 For More Information, please contact:                                                                          4765 Ogletown-Stanton Road,
 Event Coordinator
                                                   Physicians         Skilled and service workers               Newark, DE
 Social Solutions LLC
 (302) 239-4666                                    Nurses             Community Health Centers
 socialsolutions1@gmail.com                                                                             Speakers:
                                                   Social workers     Students                                 Ana E. Núñez, MD
                                                      Community-based/Non profit workers                       Drexel University College of
         ACCREDITATION STATEMENT
                                                                                                                  Medicine
   Application has been filed with the American
  Academy of Family Physicians. Determination                                                                  Marcos Pesquera, RPh, MPH
    of credit is pending. The Delaware Nurses                                                                  Adventist HealthCare, Inc.
     Association is accredited as a provider of
  continuing nursing education by the American                                                          *Continental breakfast served
  Nurses Credentialing Center’s Commission on
                   Accreditation.
         CME/CEU credit hours available.

                                                   ENROLLMENT FORM - DEL AWARE CULTUR AL COMPETENCY EDUCATION SERIES

                                                   Pre–Registration Required

                                                   Name __________________________________________________________________________________________________

                                                   Address________________________________________________________________________________________________

                                                   Phone# ________________________________   E-mail ______________________________________________________

                                                   ____   Individual sessions                             Total fee enclosed $ _____________________
                                                   ____   $15.00 General Public                           Dates (if signing up for individual sessions)
                                                   ____   $5.00 for residents & students                  _____________________________________________
                                                   ____   DAFP / DNA / NMA Members (Complimentary)        _______________________________________________
                                                          NASW Members

                                                   Mail to: Delaware Nurses Association
                                                   5586 Kirkwood Highway • Wilmington, DE 19808                   CME/CEU credit hours available.
                                                   (800) 381-0939 • (302) 998-3141 (Phone) • (302) 998-3143 (Fax)
          Education Series sponsored by
      the Delaware Division of Public Health                                     Visit www.denurses.org to register online.
Page 14 • DNA Reporter                                                                                                                                   May, June, July 2009

                        Delaware Nurses Association Consent to Run
    Nominations are open for nominations for the                      2. A person who has completed a nursing                  by the president, general membership meetings, and
following positions on the Board of Directors for the                    education program that qualifies the applicant        national meetings (as applicable for the position).
Delaware Nurses Association.                                             to take a DNA-accepted nursing board                  Special meetings and ad-hoc committee assignments
   1. P r e s i d e nt- E l e c t —T h i s p o sit ion s e r ve s        examination for registered nurse licensure as a       would be in addition to those commitments. Added
      concurrently as an elected ANA Delegate. The                       first time writer.                                    time commitments vary depending on the depth to
      President-Elect works in close collaboration                    3. Membership is unrestricted by consideration           which individual issues are pursued.
      with the President and actively participates in                    of age, creed, disability, gender, health status,
      committees of the DNA. This is a one (1) year                      lifestyle, race, nationality, religion, or sexual     Nomination Procedure
      term until the president position is assumed.                      orientation.                                             Nomination forms are available on the Delaware
      The president’s term is for two (2) years with an                                                                        Nurses Association website (www.denurses.org).
      additional one (1) year as past-president.                    Work of the Board of Directors                             They are also available from the Delaware Nurses
   2. Vice-President—In             the    absence     of    the        The Board of Directors, a corporate body composed      Association, 5586 Kirkwood Highway, Wilmington,
      President, assumes the duties of the President.               of elected members, serves as the agent for members        Delaware 19808. To request a form by phone, call
      This person is responsible for any duties                     of the DNA. Each member of the Board must uphold           (302) 998-3141 or (800) 381-0939.
      assigned by the Board of Directors and/or                     the mission, vision and goals of the Association. The         The onus is on the person nominated to submit
      President. This is a two-year term.                           functions of the Board include but not limited to the      a bona fide nomination form. That is, the candidate
   3. Treasurer—The Treasurer is required to                        following2:                                                is responsible for ensuring that the form is complete
      monitor and report on the finances of the                        1. Exercise the corporate responsibility and            and that the appropriate documentation has been
      association to the Board. The treasurer                             fiduciary duties of the Association with             provided.
      also reports on the finances at the general                         applicable provisions of law.                           All nominations are subject to a verification
      membership meetings. This is a two-year term.                    2. Provide for implementation of action and             process by the Chair of the Nominating Committee.
   4. At Large Director/Alternate ANA Delegate                            directive of DNA membership.                         A nomination will be certified as correct only if all
      (2 positions) The Alternate assumes the duties                   3. Establish policies and provide for the               the following criteria are fulfilled:
      of the delegate in the event that the delegate is                   transaction of business and coordination of             1. The Candidate is a member of the Association
      cannot attend the national House of Delegates.                      association activities in the interim between the          in good standing.
      This is a two-year term.                                            general membership meetings.                            2. The nomination form includes the candidate’s
                                                                       4. Provide for adoption of financial policies.                name, his/her consent to run.
Eligibility Requirements for Candidates                                                                                           3. Candidate     information      is completed   as
   Each candidate1 must be a member of the                          Role of the Board of Directors                                   instructed on the pages provided.
Delaware Nurses Association in good standing.                          Members of the Board of Directors are the leaders          4. The completed nomination form is received
Interested members should have some experience                      of the Association. They are responsible for ensuring            by the Delaware Nurses Association 5586
participating in the organization. Full Members as                  that all decisions are made in the best interests of the         Kirkwood Highway, Wilmington, Delaware
defined in the Association bylaws is described as:                  Association. They must ensure that the Association               19808, by 4:00 p.m. on Friday, October 16,
   1. A person who has been granted a license to                    will be handed on to succeeding generations with its             2009. Forms received after that date will not be
      practice as a registered nurse in at least one                strengths intact or improved, and its mission, vision            considered.
      state, territory, possession or the District                  and goals well supported.
      of Columbia in the United States, and who
                                                                                                                                 1.
                                                                                                                                      Special, Associate and Honorary Members are eligible
                                                                                                                                      for candidacy. Criteria for each membership are
      does not have a license under suspension or                   Time Commitment                                                   outlined in the Delaware Nurses Association bylaws
      revocation in any state, territory, possession or                Meetings of the Board of Directors shall be held               under Article V, Section 2.
      District of Columbia in the United States.                    at least four (4) times annually at a time and place         2.
                                                                                                                                      For full explanation of the functions of the Board
                                                                    determined by the Board of Directors. Candidates                  of Directors can be found in the Delaware Nurses
                                                                    should be able to attend board meetings as called                 Association bylaws under Article VIII, Section 6.




                                                                                                                                Consent to Run
                                                                                                       I give consent to have my name placed in nomination for an elected
                                                                                                    position for the Delaware Nurses Association. If elected, I will be free to
                                                                                                    fulfill my commitment as defined by the DNA bylaws and will be available to
                                                                                                    attend meetings.

                                                                                                    Signature _________________________________________________________________

                                                                                                    Date ______________________________________________________________________

                                                                                                    Name (please print) _______________________________________________________

                                                                                                    Address __________________________________________________________________

                                                                                                    ___________________________________________________________________________

                                                                                                    Phone (work) ______________________________________________________________

                                                                                                    (home) ____________________________________________________________________

                                                                                                       Please supply the following information to be printed and distributed to
                                                                                                    the membership prior to the elections. Please include an electronic photo
                                                                                                    that will be printed with your brief biography.

                                                                                                    Educational Preparation:


                                                                                                    Current Employer:


                                                                                                    Current Position:


                                                                                                    Employment background in nursing:


                                                                                                    Current or previous DNA involvement:


                                                                                                    Position statement (75 words or less):




                                                                                                         Please contact the Delaware Nurses Association with any questions
                                                                                                                                 at (302) 998-3141.
May, June, July 2009                                                                                                                           DNA Reporter • Page 15



    Data Bits
      Dot Baker, RN, MS(N), CNS-BC, EdD                        Professional & Resource Organizations offer
    Professor, Nursing, Wilmington University                education via newsletters, reports, position &
                                                             white papers, programs, services, interactive tools,
                         Nursing      Education:     A       continuing education, & listservs. Examples include:
                      thesaurus inventory for the
                      term “educate” revealed a               Emergency Nurses Association (ENA)                       http://www.ena.org/
                      plethora of primary and
                      supportive      action    verbs.        Oncology Nurses Association (ONS)                        http://www.ons.org/
                      Primary      verbs    such    as
                                                              National Association of School Nurses (NASN)             http://www.nasn.org/
                      educate, inform, instruct,
                      school, train, tutor, alert,            American Association of Colleges of Nursing (AACN)       http://www.aacn.nche.edu/
                      coach, and edify indicate
                      rather powerful initial and             National League for Nursing (NLN)                        http://www.nln.org/
                      ongoing actions. Supportive
                      verbs suggest broad, deep,              American Heart Association (AHA)                         h t t p :// w w w. a m e r i c a n h e a r t . o r g /p r e s e n t e r.
     Dot Baker        and ongoing actions to                                                                           jhtml?identifier=1200000
                      support education as a                  American Cancer Society (ACS)                            http://www.cancer.org/docroot/home/index.asp
continuous process. Here are the lists:
                                                              Sigma Theta Tau International (STTI)                     http://www.nursingsociety.org/default.aspx
 Primary                Supportive Verbs
   Verb                                                       Joint Commission (JC)                                    http://www.jointcommission.org/
 educate    educate, lecture, explain, show,
            demonstrate, clarify
                                                             such as primary care, longterm care, managed care,        focus topics such as children’s dental health month
 inform     tell, update, enlighten                          mental health, patient safety & quality, minority         and eating disorders @ http://medlineplus.gov/
                                                             heath, child/adolescent health, women/men’s health,
 instruct   teach, train, coach, education, inculcate        preventive health, chronic disease, costs & fi nancing,      Occupational & Safety Health Administration
 school     train, educate, teach, prepare, instruct         etc.                                                      (OSHA)–features hospital e-tool with safety modules
                                                                                                                       in multiple areas (e.g., administration, clinical
 train      teach, coach, educate, instruct, guide,             AHRQ’s Health Care Innovations Exchange @              services, emergency, housekeeping, ICU, pharmacy,
            prepare, tutor, school, exercise, work           http://www.innovations.ahrq.gov/ profi les new ideas      surgical suite, healthcare wide hazards) @ http://
            out, keep fit, aim, direct, focus                to improve patient care delivery. The innovations are     www.osha.gov/SLTC/etools/hospital/index.html
                                                             carefully described and evidence-rated.
 tutor      teach, educate, instruct, coach, train,                                                                      Nursing Center.com @ http://www.nursingcenter.
            lecture                                            Learn and Network connects users to literature,         com/home/index.asp offers numerous resources
 alert      warn, forewarn, notify, tell, inform             guest perspectives, Webinars, and podcasts.               such as news updates, readings, learning center,
                                                                                                                       webcasts, and continuing education.
 coach      teach, train, prepare, instruct, tutor, drill       MULTIPLE       INFORMATION          MEDIA–reports,
                                                             newsletters, audiovisuals, training guides, health          AHRQ—list of health services research @ http://
 edify      enlighten, inform, educate, instruct,            information, clinical trials, professional organization   www.ahrq.gov/news/pubcat/c_hsrv.htm
            improve, teach                                   resources
                                                                                                                       SIMULATION education–
    Nurses are both obligated and privileged to                 Robert Wood Johnson Foundation (RWJF) @                    Using simulation education for undergraduate
educate themselves and their constituents. As                http://www.rwjf.org/                                      education @ http://www.ncbi.nlm.nih.gov/pubmed/
educators, nurses must continuously be curious—                 Program areas: building human capital, childhood       15673172
to raise questions about their practice, profession,         obesity,    healthcare     coverage,   public  health,        Simulation as teaching strategy for nursing
interests, and prospects. Nurses must be active              vulnerable populations, quality/equality, pioneer/        education & orientation in cardiac surgery @ http://
and proactive to be aware, fi nd, employ, and                innovative solutions.                                     ccn.aacnjournals.org/cgi/content/full/24/3/46
communicate a variety of methods and resources to               (1) Newsroom releases audio, video, articles, and          Simulation Education & Training Center (SimET)
fulfi ll knowledge and education needs. Nurses must          commentaries. For example, Feb 2009–report about          @ Banner Good Samaritan Medical Center [videos] @
also serve as writers, reviewers, editors, researchers,      how tobacco companies have increased marketing            http://www.bannerhealth.com/Locations/Arizona/
etc. in order to contribute to and advance nursing           toward women and girls. (2) Publications include          B a n n e r + G o o d + S a m a r i t a n + M e d i c a l + C e n t e r/
information and resources. Nursing is dynamic—               journal articles, reports, policies, books, grant         P r o g r a m s + a n d+ S e r v i c e s/S u p p o r t+ S e r v i c e s/
thus nurses as educators must precede and                    results, meeting highlights, toolkits. (3) Subscribe      Simulation+Education.htm
supersede those dynamics so that we are superlative          to e-mail updates @ http://www.rwjf.org/services/             Laerdal site and NLN publications @ http://www.
role models in and for our profession.                       updateemail.jsp. News Digests, Advances (monthly          laerdal.com/document.asp?subnodeid=27282846
    This column features a variety of resources that         report on projects & progress), Content Alerts about          High-fidelity simulation in nursing education (2010)
we can use to fi rst educate ourselves. Then, nurses         publications in topics of your choice, Synthesis          @ http://www.jbpub.com/catalog/9780763756512/
have quintessential opportunities to ignite a spark          Project (issue briefs, research reports). RWJF work in        “Emerging Technologies in Nursing Education”
of natural and necessary curiosity at many levels            areas such as: addictions, palliative care, longterm      Conference (2009) @ http://www.cforums.com/
(i.e., among ourselves, clients, families, colleagues,       care, medical malpractice, nurses & nursing, obesity,     m413309/fac.asp
students, organizations, and local and global                etc.                                                          Incorporating scenario-based simulation into a
communities). We can fuel that spark and perpetuate                                                                    hospital nursing education program (2009) @ http://
lifelong learning as we enact our obligations and              American Hospital Association (AHA) @ http://           www.jcenonline.com/view.asp?rID=35907
privileges as nurse educators.                               www.aha.org/. Advisories, news releases, databases,           Simulation         in     nursing        education:           From
                                                             subscriptions to newsletters, management, and             conceptualization to evaluation (2007) @ http://www.
  LISTSERVS–electronic          subscriptions         that   network information                                       nln.org/publications/Simulation/index.htm
automatically deliver to your e-mail                                                                                       Clinical Nursing Education Center for health
                                                                American Association for Longterm Care                 professionals @ http://www.legacyhealth.org/body.
   American Nurses Association (ANA) @ http://               Nursing @ http://www.ltcnursing.org/. Education           cfm?id=1032
www.nursingworld.org/ members can subscribe to               resources @ http://www.ltcnursing.org/education/
the daily “SmartBrief” listserv which summarizes             educationalresources.html                                 SPECIALIZED EDUCATION–
and links to top story news; nursing, health, and               For example: trainer guide for longterm care              American Association of Colleges of Nursing’s
medical science; trends & technology; legislative            educators, patient safety resources, fall risk            “Cultural Competence in Baccalaureate Nursing
policy and regulatory news; work/life balance; ANA           reduction toolkit, results of longterm care leader        Education” @ http://www.aacn.nche.edu/Education/
news; and SmartQuote. Recent examples of contents            survey                                                    pdf/competency.pdf
include: more RNs get MSN degrees, exposure to                                                                            Health Resources and Services Administration
workplace solvents may increase risk of lymphoma,              Mayo Clinic home page and link to subscribe to a        (HRSA)     (2008)   numerous    tools,  standards,
secondhand smoke raises risk of dementia, few                newsletter @ http://www.mayoclinic.com/                   information about Cultural Competence Resources
women adopt healthy practices before pregnancy, ICU                                                                    for Health Care Providers @ http://www.hrsa.gov/
nurses seek balance between emotions & education,              Johns Hopkins Health Information Publications           culturalcompetence/
N.J. residency program helps single moms become              @ http://www.johnshopkinshealthalerts.com/alerts/            City of Hope oncology @ http://www.cityofhope.
nurses.                                                                                                                org/educ at ion/hea lt h-professiona l-educ at ion/
                                                                Clinical Trials.gov–search for clinical trials,        nursing-education/Pages/default.aspx
   Agency for Healthcare Research & Quality                  obtain investigator instructions and background &
(AHRQ) @ http://www.ahrq.gov/ offers multiple                links to other consumer health information from the       SOURCES OF DATA about nursing & nursing
listservs: (1) Health Information Technology listservs       National Institutes of Health @ http://clinicaltrials.    education–
(2) Patient Safety Network (3) Talking to Consumers          gov/                                                         Bureau of Labor Statistics 2008-2009 nursing
about HealthCare Quality (4) Morbidity & Mortality              Medline Plus® –search for information about            labor outlook @ http://www.bls.gov/oco/ocos083.htm
on the Web (Web M&M) (5) Research Activities (online         health topics, drugs & supplements, news. Features
newsletter) with most current fi ndings about areas          interactive tutorials, surgery videos, senior health,                                       Data Bits continued on page 16
Page 16 • DNA Reporter                                                                                                                       May, June, July 2009
Data Bits continued from page 15
                                                        “Nine Tenths of Education is Encouragement”
  NLN Nursing Education Research @ http://www.
nln.org/research/index.htm
                                                                        Anatole France                              The staff referred to these leaders as “suits”. This tactic
                                                                                                                    resulted in staff hiding and becoming nervous or
RESEARCH IN NURSING EDUCATION–                                                                                      unable to think clearly to answer correctly.
   National League for Nursing research priorities in                                                                  Beebe Medical Center in Lewes, Delaware wanted to
nursing education @ https://www.nln.org/research/           Jennifer L. Hargreaves earned her Bachelor of
                                                         Arts from Catawba College in Salisbury, North              make the educational experience fun and rewarding
priorities.htm                                                                                                      while achieving success with the NPSG’s. One of
   International Journal of Nursing Education            Carolina where she majored in Psychology in 1993.
                                                         She acquired a nursing diploma from Beebe School           the main initiatives, “Beebe Bucks”, came out of the
Scholarship (2008) “Developing a self-concept of                                                                    Periodic Performance Review (PPR) team formed in
nurse in nursing students” @ http://www.bepress.         of Nursing in Lewes, Delaware in 2001.
                                                            Jennifer has been employed at Beebe Medical             2007.
com/ijnes/vol5/iss1/art5/                                                                                              These coupons or “bucks” were created so staff
                                                         Center for over 12 years. Her nursing experience
                                                         spans over Critical Care, Same Day Surgery,                could earn rewards for being informed. One buck was
   EVIDENCE-BASED REPORTS–search “nursing                                                                           given for each correct answer. Five “bucks” could be
education” at the Cochrane Collaboration. Examine        and Gastroenterology. Currently she is a clinical
                                                         education specialist and coordinates the summer            redeemed for a small prize or snack coupon. Not only
the evidence and determine how you can use the                                                                      did the staff respond, they quickly realized they could
findings and conclusions in your practice setting,       extern program and Internship at Beebe Medical
                                                         Center. Jennifer is the current Nursing Advisory           answer five questions at a time and receive their prize
in client education sessions, in staff education, in                                                                or coupon that day.
formal nursing education programs, in community          Council president as well as the vice president of the
education, in publications, and/or at a personal         Beebe school of nursing alumni association. She sits
                                                         on the Delaware Adolescence program incorporated           Kickoff Event
level.                                                                                                                 One of the first PPR educational initiatives in 2007
   Risk assessment tools to prevent pressure ulcers      board.
                                                            Jennifer can be reached at jhargreaves@bbmc.org         was held in the winter months and was comprised of
(2008)    @    http://www.cochrane.org/reviews/en/                                                                  tables with displays for the NPSGs. Some examples of
ab006471.html                                            or at her office which is (302) 645-3293
                                                                                                                    the education provided are:
   Three 2008 systematic reviews about low back                                                                       • The Infection Control Practitioner and Lab
pain treatments (i.e., antidepressants, NSAIDs,                                                                          staff collected thumb print samples and grew
intensive education @ http://www.cochrane.org/              Barbara Moulinier earned her Master of Arts from
                                                         the College of Notre Dame in Baltimore, Maryland                organisms from both clean and dirty hands to
press/wiley/TCL.2008.Issue.1_lower_back_pain_                                                                            show how important proper hand hygiene is to
cluster_FINAL.pdf                                        where she majored in Human Resource Management
                                                         and Health Care Administration.                                 prevent infections. The slides were very visual
   Continuing education meetings and workshops:                                                                          and made a lasting impression.
Effects on professional practice and healthcare             During her career, Barbara has held several
                                                         leadership positions including President of Reick            • The Patient Access Department and Lab staff
outcomes @ http://www.cochrane.org/reviews/en/                                                                           worked together to illustrate the importance of
ab003030.html                                            and Associates which specialized in performance
                                                         improvements; Vice President Quality and Support                accuracy and checking the two identifiers (name
   Nursing record systems: Effects on practice &                                                                         and date-of-birth) when comparing the patient to
outcomes @ http://www.cochrane.org/reviews/en/           Services, director positions overseeing Medical
                                                         Records, Patient Access, Quality Programs and Joint             the requisition form. Some tricky examples were
ab002099.html                                                                                                            provided to prove the point of how easily mistakes
   School-based interventions to promote physical        Commission.
                                                            In 1998, Barbara relocated to Rehoboth Beach                 can be made.
activity and fitness in children and adolescents                                                                      • The Risk Management Department had a display
aged 6-19 years (2009) @ http://www.cochrane.org/        and is currently responsible for Joint Commission
                                                         and Process Redesign.                                           to help all staff understand the Falls Prevention
reviews/en/ab007651.html                                                                                                 policy and visual materials such as color-coded
   Types of urinary catheters for short-term voiding        Barbara can be reached at bmoulini@bbmc.org or
                                                         at her office which is (302) 645-3116.                          armbands used to easily identify patients at risk
problem management (2008) @ http://www.cochrane.                                                                         for falls.
org/reviews/en/ab004013.html                                                                                          • Nurses from the OR and Patient Care Units
                                                           In November 2003, The Centers for Medicaid and                discussed each element of Universal Protocol and
                                                        Medicare Services (CMS) and Joint Commission                     how important they are to patient safety.
                                                        (JC) began working together on unified measures
                                                        to improve patient safety called the National Patient          Over 150 team members joined in the fun to learn
                                                        Safety Goals (NPSG). In subsequent years, these             about Joint Commission and Medicare initiatives to
                                                        agencies continued to enhance their requirements and        make our patients safer.
                                                        standards of care, which can directly effect the level of      As the team became more experienced, other
                                                        reimbursement received. It can no longer be assumed         initiatives were held including special days when the
                                                        that hospitals will be reimbursed for hospital acquired     PPR team disguised as Cash Cab look-alikes, would
                                                        infections, bedsores, or other conditions and “never        ride the elevators and walk the stairwells encouraging
                                                        events” that can and should be prevented. With these        the team members to double their coupons by
                                                        national initiatives, educating team members became         answering tougher questions. Over 300 questions
                                                        even more imperative to the safety of our patients and      were asked in a one-hour time frame with many team
                                                        the financial stability of the organization.                members taking the chance to double their winnings.
                                                           In the past, our ongoing education was generally            In an effort to reach out to our many satellite
                                                        through members of the leadership team out among                                     Nine Tenths continued on page 17
                                                        staff asking questions and inspecting for compliance.
May, June, July 2009                                                                                                                     DNA Reporter • Page 17
Nine Tenths continued from page 16
locations, members of the PPR team ventured out
                                                                 Continuing Education Committee News
with questions, candy, prizes, popcorn and peanuts
to make sure every member of the Beebe family could                  Nancy D. Rubino, EdD, RNC and                        • The rules for logo usage were revised.
participate.                                                            Mary Lou Hamilton, MS, RN                         • A provider is ineligible for accreditation or
    With the great success of the “Beebe Bucks” the          Co-chairs, DNA Continuing Education Committee                  approval (approval of an activity or approval as a
team then decided to take a quantum leap and hold a                                                                         provider) if it is a commercial interest as defined
fun fair we called the “Backyard Bash” in July, 2008.         Continuing Education Committee Accreditation                  in the “Standards for Commercial Support.”
This fair was held in our “backyard” and included                 The American Nurses Credentialing Center’s              • As previously, the nurse planner must have
various stations which represented a different National       Commission on Accreditation granted accreditation             education or experience in the field of education
Patient Safety Goal and problem-prone standards              to the DNA CE committee as an approver unit for four           or adult learning. This revised manual
within the Environment of Care and Emergency                          years from February 2009 through                      provides further guidance on evaluating the
Management plans. We also reinforced our initiatives                            February 2013.                              “experience in the field of education or adult
for the Core Measures. Dunking tanks, moon walk,                                                                            learning” by stating that “The nurse planner
duck pond, popcorn and peanuts were added to the              The Delaware Nurses Association is accredited                 must demonstrate competence in performing
fun fair theme.                                               as an approver of continuing nursing education                successfully at the expected level. Accepted
    These individual stations were designed to be quick       by the American Nurses Credentialing Center’s                 demonstration of competence can be evaluated
and educational. On this day, ten Beebe Bucks could                   Commission on Accreditation.                          by review of the nurse planner’s professional
be cashed in for three balls to dunk the President,                                                                         portfolio.”
Chief Operating Officer, Vice Presidents of Patient           ANCC Criteria Changes                                       • Conflict of interest must be disclosed relative
Care and Medical Affairs, along with several directors          The following is a summary of changes to the                to each activity. An original signature is not
and members of the Medical Executive Committee. Of           ANCC Accreditation Manual:                                     required. However, if an original signature is not
course, for those of us who could not throw a ball, we          Specific areas of change include (but are not                used, the unit is advised to keep documentation
were able to cash in our coupons for prizes.                 limited to):                                                   supporting the source of the information.
    The response and turn out was amazing. Over                • The minimum amount of contact hours that may             • Enduring documents must include a statement
200 team members from both clinical and non-                      be awarded for an educational activity is 0.5             that explains how long contact hour(s) will be
clinical departments answered over 1200 questions.                contact hours (30 minutes).                               awarded for an activity. This statement must
The questions were colored coded so that appropriate           • Provider units that targeted more than 50%                 appear on all marketing materials and on the
questions were available for each group and some                  of their educational activities provided in the           title page of the educational materials.
questions could be answered by anyone. The most                   previous calendar year to nurses in multiple            • Criterion 3 now addresses unit operations.
popular prize was of course the three balls for the               regions (use the DHHS regions: http://www.hhs.          • Criterion 4 now addresses unit outcomes
dunk tanks. Our largest satellite location held a mini-           gov/about/regions/), must apply to be accredited          evaluation.
Backyard Bash as well with dunk tanks, prizes,                    providers.                                              • The provider is tasked with identifying the
fun and games to ensure everyone had the same                  • Continuing Nursing Education units that                    appropriate people to be involved in the
opportunity to participate in the learning experience.            targeted more than 50% of their activities                evaluation of the provider unit.
    The need is very real for every member of the Beebe           provided in the previous calendar year to the             • Specific approved provider criteria have been
staff, physicians and volunteers to support our culture           nurses in a single state or region (or a state                included in Appendix F.
of safety and have a thorough knowledge of the patient            contiguous to that region) may apply to a                 • Specific peer review/approval instructions for
safety goals, core measures, and the environment of               Constituent Member Association for approval as                the learner-directed activity are included.
care.                                                             providers.                                                • A statement for the activity ‘pending approval’
    The newest 2009 initiative by our PPR team                 • A fourth category of accredited approver was                   is provided.
is conducting mini-tracers. These tracers take                    added—the national nursing organization                   • Specific monitoring requirements of the
approximately 15 minutes and provide us with valuable             based outside the United States. It may approve               accredited approver unit are identified.
statistics on compliance. In addition, the data collected         activities or providers within its constituency           • Definitions in the glossary were added and
serves as the basis for the annual periodic performance           (within its country).                                         revised.
review scores and allows us to continuously make               • Lead nurse planner responsibilities are clarified.         • Approved providers may co-provide activities.
improvements in our educational programs.                      • Nurse planners must maintain expertise in                  • Approved activities may be co-provided.
    In the spring, we will be holding a Room of Horror            educational design and adult learning theories,               The Commission on Accreditation may
filled with lots of errors to help staff visually identify        receive orientation to, and maintain responsibility           decide to grant probationary status to a re-
problems related to some of the Joint Commission’s                for implementing ANCC Accreditation Program                   accreditation applicant.
focused areas.                                                    criteria in their performance of the nurse
    Through doing tracers and questioning staff                   planner role.                                            All currently approved providers of continuing
after each special event, there has been a significant         • Supporting evidence is clearly referred to as          nursing education must implement the changes
improvement in retention and understanding of the                 “required” evidence.                                  in 2009. Look for revised manuals and documents
patient safety initiatives. “Beebe Bucks” are still being                                                               coming from the CE Committee.
distributed on the units by staff and managers. By
using positive reinforcement team members were more
apt to approach us for the questions rather then us



                                                                             e New einstated
hunting them down.



                                                                       Welcom and R
    In an effort to be proactive, Beebe School of Nursing,
in conjunction with the instructor’s Masters project,



                                                                                               embers!
presented a conference, “Nurse as Teacher”, for the
first year students. Part of the thesis focused on the
socialization of student nurses to the role as teacher
through education of national organizations especially
the ANA. The focus was the “teachable moment” and
ways to take advantage of these moments in everyday
                                                                                             M
care. As the senior students at our School of Nursing
are rotating through clinical area, they are given the
opportunity to work with us to assist with tracers,                 Daaimah Aleem—Claymont                 Sylvia Judd—Camden                Tracy Patrick-Panchelli—
environment of care surveys, Emergency Management                                                                                                   Exton, PA
                                                                      Grace Ampofoh—Dover              Nishelle Denise Harris-Hines—
drills, and mini-tracers.        Their participation will
                                                                                                                 New Castle               Anya Bostian Peters—Hockessin
provide the PPR team with new ideas for new                           Karen Cannon—Milton
generations and help us design materials which are                                                        Sharmila Johnson—Bear              Jeanette Panunto—Dover
both educational and fun.                                              Caren Coffy—Newark
                                                                                                          Nora Katurakes—Wilma                Bonnie Perratto—Dover
                                                                       Ann Darwicki—Bear
How did we know we were successful?                                                                       Kathleen King—Newark             Melissa Raffaele—Harrington
   It was during our recent Joint Commission survey               Julianne DeRosa—Wilmington
where the results of all of these efforts became obvious.                                                 Moonyeen Klopfenstein—             Karen Ridley—Wilmington
                                                                     Leslie Eisenbrey—Dover
When several of our team members very confidently                                                               Wilmington
                                                                                                                                             Kristina Santoro—Newark
answered the Joint Commission surveyor’s questions                   Susan Felicia—Hockessin
                                                                                                       Mary Theresa Lednum—Bear
correctly, and then said “don’t I get a Beebe Buck?”                                                                                         Lori Shiflett—Wilmington
                                                                Erlease Freeman-Goldsborough—
The surveyor laughed and complimented us on how                                                            Susan Davies Lloyd—
                                                                           Wilmington                                                       Michelle Sipple—Wilmington
comfortable our staff was during the entire survey and                                                       West Chester, PA
how well educated they were on the importance of the               Jean Gallagher—Wilmington                                                   Joan Thomas—Milton
                                                                                                       Fairuz Jazmin Lutz—Frederica
NPSGs, core measures, and other standards.
   The success of the initiatives at Beebe Medical Center           Beryl Gamiel—Wilmington                                                   Christina Trout—Lewes
                                                                                                         Frances Morthole—Seaford
is due to the creativity and personal commitment                 Jennifer Graber—Landenberg, PA                                                 Mary Torsch—Dover
of the PPR team members, the receptiveness of the                                                      Cheryl Nicholson—Middletown
entire Beebe family to be a learning organization, and            Kelley Lester-Garrett—Newark                                                Virginia Wagner—Bear
                                                                                                              LaTonya Mann—
the financial support we have been given to continue                                                          Penns Grove, NJ
                                                                         Margaret Gatti—                                                         Yabo Yu—Newark
our Beebe Bucks and prizes during a time when cost
                                                                           Ocean View
containment is so important. We truly appreciate all of                                                Amanda Klockars-McMullen—
the support to keep laughing, keep having fun, and to                Darralyn Jannai Hall—                    Warwick, MD
keep learning every day at the Medical Center.                             Wilmington
Page 18 • DNA Reporter                                                                                                            May, June, July 2009


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