ENHANCING THE COMPETENCY OF THE CORRECTIONAL NURSING WORKFORCE THROUGH A COLLABORATIVE APPROACH: PROCESS AND PROGRESS
Louise Reagan MS, APRN, ANP-BC Assistant Clinical Professor
University of Connecticut School of Nursing
Deborah Shelton, PhD, RN, NE-BC, CCHP, FAAN E. Jane Martin Professor
Associate Dean for Research & Graduate Research Programs
West Virginia University, School of Nursing Desiree Diaz PhD, RN, CNE
Associate Clinical Professor University of Connecticut School of Nursing
Michael Nicholson, RN, MBA
Director of Education and Training
University of Connecticut Health Center Correctional Managed Health Care
University of Connecticut
EDUCATIONAL OBJECTIVES
By the end of this presentation, participants will:
Describe challenges for implementing a competency
program for nurses within a statewide prison system.
State the processes and components for establishing a
correctional nursing competency system.
Identify how various education modalities and delivery
options including on-line modules, high and low fidelity simulation, mobile simulation van and skill based
sessions are used within the described correctional nursing competency system.
FACULTY DISCLOSURE
“We do not have any
relevant financial relationships with any commercial interests.”
University of Connecticut School of Nursing
SPECIAL THANKS TO OUR TEAM:
University of Connecticut Health Center: Constance Weiskopf, PhD, RN, APRN
CT Department of Correction Partner: Tracey Butler, MA
University of Connecticut School of Nursing: Denise Panosky, DNP, RN, CNE, CCHP, FCNS
CORRECTIONAL NURSING EDUCATION AND TRAINING
CORRECTIONAL NURSING COMPETENCY
PROGRAM © DEVELOPMENT IN CONNECTICUT
The setting
Our state system
443 licensed nurses (3 female:1 male; 70% RN)
18,000 incarcerated men and women in
CORRECTIONAL NURSING COMPETENCY
PROGRAM © DEVELOPMENT IN CONNECTICUT
The Challenges
Unique setting with constantly changing safety
and security concerns
Increase in complexity of inmate patients chronic
illness, mental health and substance abuse disorders (Shelton et al., 2010; Wang & Green, 2010)
CORRECTIONAL NURSING COMPETENCY
PROGRAM © DEVELOPMENT IN CONNECTICUT
The Challenges
No formalized educational preparation for
correctional nurses
Limited continuing education correctional nursing
education programs
No standardization of correctional nursing
education programming
Few aspects of correctional nursing have been
empirically tested or published regarding the translation of ANA standards into practical and applied competencies.
CORRECTIONAL NURSING COMPETENCY
PROGRAM© DEVELOPMENT IN CONNECTICUT
The OPPORTUNITIES
Established ANA Professional development
model (2007) and tested correctional workforce development strategies (Mansfield et al, 1997; Storey et al., 2002).
An Interprofessional Partnership
NURSING DEVELOPMENT FRAMEWORK
©Phases Phase 1 Phase 2 Phase 3 Phase 4 Phase 5
Timeline Pre-Orientation Prior to facility placement 4-6 weeks close mentoring & supervision Mentored through the first year
Life-long learning process Content Focus DOC Academy
Security and safety focus Nursing Orientation What is a Correctional Nurse? Nursing orientation in assigned facility Probationary period Extended nursing orientation
May rotate other units, other facilities Professional Development Demonstrate continued Nursing competency with annual evaluations Content Design Self-assessment of
skills Alignment with Correctional Nursing Philosophy Key points to hit the ground running
Nurse point of entry issues
High use/high risk clinical skills focus Begin the mentoring relationship - retention requires this Develop the correctional
nurse “we” envision for retention Continue mentoring Have more than one expert mentor Supervisor has special responsibility for retention- frequent meetings Shift in
responsibility for proof of continued competency to nurse with support Standard-based portfolio Nursing rounds:
literature &case review groups
Award CEU’s for certification
Property of Shelton et al, 2013. Do not cite, reproduce, or use in training without the explicit permission or the author © 2013.
CORRECTIONAL NURSE COMPETENCY PROGRAM ©IMPLEMENTATION
Securing HRSA grant funding for Competency Program Phase 5 Implementation and pilot testing
Unpacking the NEPQR Grant :
Advancing Correctional Nurse Competencies for
CMHC Competency Project
Leadership Education Simulation
Evaluation
ADVANCING CORRECTIONAL NURSE
COMPETENCIES FOR QUALITY CARE: COMMITTEE STRUCTURE
CORRECTIONAL NURSE COMPETENCY PROGRAM © IMPLEMENTATION Bringing committees to life Skill based Sessions Participative processes to create educational modalities and develop effective delivery options
Simulation scenarios E-based modules EVP/ Pilot testing the program
THE LEADERSHIP TEAM: THE GUIDING FORCE
Bringing
committees to life
Selecting members from CMHC staff for Education and Simulation
1. Is the scene safe and secure?
◦ Has CDOC ensured your safety and security? ◦ Any environmental hazards? Water on floor
◦ Is there a need for personal protective equipment, e.g. gloves, gowns? Blood or body fluids
◦ Is the area a crime scene and in which you need to preserve evidence? Shank on ground
◦ Are there multiple patients needing triage?
Property of Shelton et al, 2013. Do not cite, reproduce, or use in training without explicit permission of the author © 2013.
EDUCATION COMMITTEE: PRE-TEST
Correctional Managed Health Care Pre-Simulation Module #3
◦ Complaints related to the neurologic system
Dizziness Read CMHC protocol, click here
Altered mental status Read CMHC protocol, click here
Seizures Read CMHC protocol, click here
Headache Read CMHC protocol, click here
Property of Shelton et al, 2013. Do not cite, reproduce, or use in training without explicit permission of the author © 2013.
EDUCATION COMMITTEE: LINK TO ACADEMIC RESOURCES
EDUCATION COMMITTEE: SKILL BASED SESSIONS
Property of Shelton et al, 2013. Do not cite, reproduce or use in training without the explicit permission of the author (c) 2013.
Superusers N=48 Simulation Team N=60 Core Simulation Team N=12
Facility Based Educators
Supervisors
Identified Interested Users
Identified Educators from Partners, Education Director,
Education Committee Rep,, supervisors and staff at each
facility
SIMULATION COMMITTEE: CREATE SIMULATION 1
Property of Shelton et al, 2013. Do not cite, reproduce or use in training without the explicit permission of the author (c) 2013.
EDUCATION MODALITIES: PUTTING IT ALL TOGETHER
E-PORTFOLIO
CHALLENGES
•Limitations of the existing system •Funding
NURSING SATISFACTION WITH PROGRAM SATISFACTION THEMES
Pre-Simulation (Q 1-2) Rating
Understanding and Preparation 4.6
Simulation (Q 3-7, 10, 18)
Integration and Decision Making 4.4
Debrief (Q 14-17)
Understanding Rationales, Strengths,
and Weaknesses 4.7
Learning (Q 8, 9, 11-13,19)
Implementation and Confidence 4.7
Overall satisfaction with project
SNAPSHOT SUMMARY OF SELF-REPORT PRETEST POSTTEST SCORES
Nurses who worked 3yrs < experience in corrections perceived fewer benefits than nurses >4 yrs. experience in corrections RNs felt they were more knowledgeable
NEXT STEPS
Roll out of Portfolio for nurses
Phase 2 – address standardized instruments Fidelity Study
Linking nursing competency to patient outcomes
Development of Center for Correctional
Practice-based Research Network & the Council for Correctional Nursing
REFERENCES
American Nurses association (2007).Corrections Nursing:
Scope and Standards of Practice. Silver Springs,MD:author.
Institute of Medicine (2010). The Future of Nursing: Leading
Change, Advancing Health. Washington D.C.: The National
Academies Press:
Mansfield
Shelton, D., Weiskopf, C., & Nicholson, M. (2010).
Correctional Nursing Competency Development in the Correctional Managed Health Care Program. Journal of Correctional Health, 16:299.DOI:
10.1177/1078345810378498
Shelton et al., 2010L
