Advanced Practice Nursing professional development

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Advanced Practice Nursing professional development: “STARS” model – aligning your practice for team and personal advancement Monica Hente, RN, MSN PPCNP-BC, BMTCN®, CPON®, Debbie Woods, RN, MSN, CPNP-PC, Emily Daut, RN, MSN, PPCNP-BC, CPHON®, Katie Gettinger, RN, MSN, CPNP-PC, Kelsie Hankins, RN, MSN, CPNP-AC, Juli Kiefer, RN, MSN, CPNP-PC, Caroline Mohrmann RN, PhD, CPNP-AC, Ginny Schulz, RN, MSN, CPNP-PC, Alison Towerman, RN, MSN, CPNP-PC

Background • There was significant growth of advanced practice nurses (APNs) in the Division of Pediatric Hematology/Oncology from 20132015. The group grew from 5 to 12 APNs. • Sudden growth resulted in conflict and role confusion.

Study Purpose The primary objective was to utilize a professional practice model for APNs to improve teamwork and communication, and to develop team and individual professional goal.

STARS Model of Shared Leadership Superior Patient Care

Teaching Teamwork

• Journal club • Professional development • Mentoring pairs for collaboration and development • Liaison for professional practice (organized journal club, biannual retreat, legacy)

• PNP orientation and ongoing education • Fellow education • Staff nursing collaboration and communication • Liaison positions: Fellow/NP Training Liaison, Staff Nurse Liaison

Methods 1. Identified problems in communication, interpersonal interactions, and balancing of unit-required care with individual professional activities. 2. Organized retreat with the assistance of human resource personnel. 3. Identified mission statement, team and individual goals, and methods for dividing institutional-required activities while also promoting individual program activities. 4. Included development of format for conflict resolution.

Mission Statement The APN group supports the Hematology/ Oncology mission of high quality and safe care for all patients and families as their primary mission. In addition, the APN group will be active participants in all divisional goals related to fellow and nursing education, medical and nursing research, program development, and professional development. The APN legacy work and shared leadership model will align with both hospital and divisional goals.

Accountability • Interface with Hospital APN committee • OPPE • Interface with unit based joint practice committee • Leadership positions: APN Professional Practice Liaison, Leadership APN Liaison, Operational APN Liaison

Research • Clinical trial participation • Participation in nursing research/QA projects or individual research projects • Liaison position: Clinical Trial Compliance Liaison

Safety • IT interface (all roadmaps and orders electronic) • Safety and QA projects • Liaison positions: Patient Safety and Quality Liaison, IT Liaison

Outcomes Implementation • Incorporated into monthly APN meeting with agenda items in STARS format • Utilized method for staying focused on common goals • Completed ongoing evaluations at biannual retreats • Created pathway for conflict resolution • Created necessary joint leadership structure


• . • Liaison positions divided workload for administrative responsibilities, allowing others to pursue interest areas • Legacy work promoted and improved interpersonal relationships (see grid) • Promoted objective means to establish clinical pathways, institute evaluations, plan individual professional goals, and identify clinical expectations

Barriers • Maintenance of self governance takes high level of commitment. • New graduates often initially intimidated by legacy process. • Need buy-in from administration.

References Available upon request.

Conclusions The STARS model has been in effect for 3 years and has brought  structure to a large APN group that now includes 18 APNs.  The  use of this model has led to increased communication,  teamwork, structured orientation, and an objective means to  maintain focus on team and individual goals. The next steps of  model implementation will be formal evaluation and tracking  of APN outcome measures.