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by Elaine Joyal, RN, Magnet project coordinator for The Miriam Hospital (Published July 15, 2002, Nursing Spectrum) In January 1998, The Miriam Hospital in Providence, RI, was the ninth hospital in the United States to be designated Magnet status. One year later, the hospital experienced restructuring and downsizing, followed by some difficult times. The Miriam Hospital department of nursing designed a unique process to prepare for redesignation. The CNO appointed a Magnet project coordinator who organized a structured, focused action plan to complete the written documentation. In addition, a Magnet steering committee was appointed for standards review and involvement in joint decision making. Led by a chief nursing officer (CNO) supportive of professional practice, the department of nursing undertook extensive rebuilding in response to the importance of upholding the 14 Magnet standards. After reviewing the revised standards, it was apparent much work was ahead. However, the nursing leadership group felt the journey would be a worthwhile one. Major initiatives in the redesignation process included staff nurse participation, quality improvement, implementation of nursing research protocols, movement toward evidence-based practice, and attention to cultural and ethnic diversity. Staff nurses were integral in the redesignation process and became active participants on organizational committees, teams and task forces. The unit councils, comprised of motivated staff nurses, represented the structure for unit-based decision making. At the unit level, with the support of nurse managers, staff nurses discussed quality improvement issues and implemented positive change. The nursing department recognized the importance of linking nursing's contribution to quality patient care, which demonstrates professional value. Quality improvement initiatives focus on nursing-sensitive indicators, such as pressure ulcers and patient falls. One process implemented last year to promote compliance with the standards was the implementation of the skin care task force led by a clinical specialist and a group of staff nurses responsible for monthly pressure ulcer prevalence data. In addition, the department of nursing implemented the Hendrich Fall Risk Model as an evidence-based fall risk assessment method and a revised fall prevention program. Fall rates are being monitored and trended over time. Another change to improve quality of care is the implementation of a mobilization program currently being led by the geriatric clinical specialist. The department of nursing had a structured nursing research committee. Until recently, nurses were not conducting research. To support this goal, a research specialist was hired to provide education and assist nurses with the research proposal process. Research bulletin boards were established on every unit that included information about the research process and current research relevant to the unit. Staff nurses suggest topics, which are changed every two weeks, and submit ideas for research. Attention to cultural and ethnic diversity of patients and their significant others is included in the framework of the Magnet Program. To comply with the Magnet standards and assist staff nurses in providing culturally competent care, a program entitled "Building Cultural Competence" was initiated in partnership with the diversity office and is offered monthly. Once the written documentation was completed, energy focused on preparation for the site visit. A Magnet swat team of staff nurses worked with the Magnet project coordinator. The team of staff nurses were empowered to motivate their peers and to help prepare them for the site visit. Posters were designed to represent the Magnet standards and contests were conducted to promote team spirit. The site visit was organized and proceeded smoothly. The organization worked together and showed the appraisers that The Miriam Hospital is a proud group of dedicated individuals committed to providing high quality care. The journey to Magnet redesignation was an opportunity for everyone to pursue a common goal and to maintain the prestigious national recognition for excellence in nursing service. Magnet status is a tremendous accomplishment and the process is worthwhile because of what magnet status signifies. Magnet status translates into a work environment that supports professional nursing practice and the right environment for patients and professional nurses. The department of nursing anxiously waited for five weeks to be notified of the Magnet commission's decision. February 11, 2002 was a beautiful day to complete the journey to Magnet redesignation. Now the challenge turns to keeping the Magnet standards alive. Article copyright Nursing Spectrum
Nurse Wire (www.nursingspectrum.com). |
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