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Nurses Matter: The Role of the Nursing Support Program I (NSP I) in Maryland

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(1)

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

(2)

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

(3)

The Value of Nurses

Largest group of providers in the health

care system

Nurses impact patient outcomes

Time spent with patients

Education

(4)

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.

(5)

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

(6)

The Need for Evaluation of NSP I

Review previously unanalyzed

qualitative data

Facilitate coordination and discussion

of best practices among participating

hospitals

(7)

Data Sources

NSP I Coordinator Reports

FY2009-FY2012

FY2013 NSP I Hospital Program

Descriptions

(8)

Methods: Coordinator Reports

FY2009-FY2012

Reviewed five qualitative

questions regarding activities to

improve the nursing environment

Identified and coded common

(9)

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

(10)

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

(11)

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 database

(12)

Findings: 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

(13)

Findings: Site Visits

Hospital

Date of Visit

Primary Program

Activities

Feedback on NSP I

MedStar Harbor

Hospital 4/5/13 Scholarships for Nursing staff (RNBSN and BSNMSN)

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.

(14)

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.

(15)

Limitations

Annual Reports FY2009-FY2012

Two questions were not asked on the

FY2009 and FY2010 Coordinator Annual

Report

Low response rate

FY2013 Program Descriptions

New Instrument

Site Visits

(16)

NSP I in the Context of the IOM

Recommendations for Nursing

Eight IOM recommendations are organized into four

major categories:

1.

Nurses should practice to the full extent of their

education and training

2.

Nurses should achieve higher levels of education

and training through an improved education

system that promotes seamless academic

progression

3.

Nurses should be full partners, with physicians and

other health care professionals, in redesigning

health care in the United States

4.

Effective workforce planning and policy making

require better data collection and an improved

information infrastructure.

(17)

Concluding Remarks

NSP I is an effective program for

Maryland nurses, hospitals, and

patients

Overwhelming feedback indicate that

the program has made a significant

difference in the quality of nursing care

and nurse job satisfaction

(18)

Acknowledgements

HSCRC Preceptors

Claudine Williams

Oscar Ibarra

NSP I Coordinators

PHASE Staff

Jennifer Le

Beth Resnick

References

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