Nurses Matter:
The Role of the Nursing
Support Program I (NSP I) in
Maryland
Miriam Haviland
PHASE Presentation
Maryland Department of Health and Mental Health Services
May 10
th, 2013
Presentation Overview
Value of nurses in the U.S. health care
system
NSP I background
NSP I evaluation
•
Data sources and methods
•
Findings
NSP I and IOM recommendations for
the future of nursing
The Value of Nurses
Largest group of providers in the health
care system
Nurses impact patient outcomes
•
Time spent with patients
•
Education
Overview of HSCRC
The Health Services Cost Review
Commission (HSCRC) is an independent
agency with authority to regulate 47 acute
care hospitals in Maryland.
Because of its authority, HSCRC is able
to fund programs to address hospital
nursing staff needs through rate
increases.
NSP I Background
Originally funded in July of 2001 to
address the nursing shortage in Maryland
Program provides participating hospitals
with up to 0.1% of gross regulated patient
revenue for activities
Goal of the program is to recruit and
retain high quality nurses in Maryland
hospitals
Funding renewed in July of 2012 for
The Need for Evaluation of NSP I
Review previously unanalyzed
qualitative data
Facilitate coordination and discussion
of best practices among participating
hospitals
Data Sources
NSP I Coordinator Reports
FY2009-FY2012
FY2013 NSP I Hospital Program
Descriptions
Methods: Coordinator Reports
FY2009-FY2012
Reviewed five qualitative
questions regarding activities to
improve the nursing environment
Identified and coded common
Methods: FY2013 Program
Description
Programs broken into three categories:
1.
Education and Career Advancement
2.
Patient Quality and Satisfaction
3.
Advancing the Practice of Nurses
Activities were extracted and sorted
into thematic categories
Methods: Site Visits
Four site visits conducted by HSCRC staff
during April 2013:
•
MedStar Harbor Hospital
•
LifeBridge Northwest and Sinai
Hospitals
•
MedStar Union Memorial Hospital
Findings: Coordinator Reports
Shared Governance Evidence Based Practice (EBP) Initiatives Implemented Nurse Quality Indicators Applied Nurse Research Projects New approaches to staffing and patient allocation • Councils • Retreats and other governance trainings • Quarterly newsletter • Governance training • Created EBP fellowship (GBMC) • Councils review literature and implement EBP • Support EBP research • EBP training workshop • Subscription to NDNQI • Increased number of nurses with certifications • Training and evaluation on patient safety initiatives • Research councils • EBP research practices and initiatives • Online research education programs • Nursing staff involved in Unit Design • Electronic scheduling • Subscription to Nurse Sensitive Quality Indicator databaseFindings: FY2013 Program
Descriptions
•
Scholarships for Nurses
•
Nurse Residency
Programs
•
Mentoring Programs
•
Resource Subscriptions
•
Evaluation of Nursing
Practices
•
Governance
•
Support for Special Staff
•
Training Programs
•
Initiatives to Support
Nurses’ work
•
Outreach
•
Fellowships
•
Acknowledgements
•
Evidence Based
Improvements in
Nursing Environment
and Practice
•
Other Initiatives
Findings: Site Visits
Hospital
Date of Visit
Primary Program
Activities
Feedback on NSP I
MedStar Harbor
Hospital 4/5/13 Scholarships for Nursing staff (RNBSN and BSNMSN)
Very appreciative of NSP I funds. Program is improving nursing talent and job
satisfaction.
MedStar Union
Memorial Hospital 4/26/13 Nurse Extern Program Funding from NSP I has helped to provide extra training to nursing students, especially in areas of critical care and time management. Many externs become hospital employees and are better prepared to enter the workforce.
Findings: Site Visits
Hospital
Date of Visit
Primary Program
Activities
Feedback on NSP I
LifeBridge Northwest
& Sinai Hospitals 4/26/13 Nurse Residency Program (Project Connect)
Funds from NSP I are
helping to improve nursing quality by assisting newly graduated nurses as they transition from the
classroom to the units.
Mercy Medical Center 4/29/13 • Magnet hospital activities
• Preceptor program • High School
outreach
Funding from NSP I has helped improve nurse job satisfaction. It has also helped staff collect data on their activities to better evaluate nursing quality in their hospital.