Archive: Spring 2006 | January 2007 | August 2007

Newsletter, August 2007 (download pdf file)

LEADERSHIP TRAINING PROGRAM

AN INITIATIVE OF THE ENVIRONMENT/RETENTION COLLABORATIVE

A REPORT ON THE PILOT PROJECT

While increasing educational capacity and increasing the supply of new nurses is highly important in alleviating the nursing shortage, it is equally important to retain our existing nursing workforce.  One of the key factors in retaining nurses is to provide opportunities for professional growth which allow nurses to increase competence and satisfaction, to grow in their knowledge and skills and to provide career pathways into different areas of specialization.

The Environment/Retention Collaborative developed and sponsored a leadership training for staff nurses in the charge nurse role as a retention initiative.  Front line leaders have a direct impact on the work environment.  Charge nurses have a key role in professional practice in their unit and department and have the potential to enhance patient care, peer relationships and team functioning.

Objectives of the training program were to enhance leadership skills and provide skill building in the areas of conflict resolution, communication, creative problem solving, team building and decision making.

A pilot program was conducted for 38 staff nurses from acute care facilities throughout the state on April 10 and 24, 2007.  Attendees came from ten different acute care facilities and included staff from three neighbor island hospitals.   Two one-day sessions were designed to focus on small group work utilizing exercises and scenarios to enable the learning to be applied to the work environment.  An expert in leadership development, Donna Ching, PhD, participated in the planning and facilitated both days of the program.  All expenses were paid for participants including program materials, meals, parking and airfare for neighbor island nurses.  Travel expenses were generously sponsored by AlohaCare. 

An e-mentoring component was implemented following the training to facilitate the application of skills and knowledge in the practice setting.  Participants were paired and made a commitment to set goals and objectives each month focusing on specific topic areas covered during the training session.  Pairs committed to communicating with each other once a week for a six month period by phone, e-mail and/or in-person.

An evaluation is being conducted to determine project effectiveness.  The tool utilized was a 5 point likert scale which measured Level of Confidence in Leadership Skills.  Participants completed a pre-test and a post test at the end of the 2-day session.  The tool will be completed at 3 month and 6 month intervals.  Data will be analyzed upon completion of the 6 month evaluation period. 

In addition, continuing education credits were provided by Hawai’i Pacific Health and the required program surveys were completed.  This tool measured effectiveness of the program in meeting defined objectives and allowed for written comments.  These were highly effective in providing immediate feedback to the planners.  An example is as follows:

                “When you go to the same place every day easy to see it as just
                 a job--educational opportunities like this make it more of a ‘career’
                 or a ‘profession’—great to grow and learn.”

A BIG MAHALO to all the participants in our pilot program.  Initial feedback has been very positive, and the Center is being requested to continue this program.  A business plan is being developed to allow our program to continue to be offered to nurses in all sectors of health care.  Stay tuned!

HAWAI'I REGISTERED NURSE SUPPLY SURVEY 2007

Investigator: Dr. S.A. LeVasseur PhD, RN

Introduction

Creating effective policy to ease the nursing shortage requires studying nursing workforce supply and demand at the state level. The Hawai’i State Center for Nursing, established by the Hawai’i State Legislature, is addressing a number of issues that impact the nursing shortage. One major function of the Center is the collection of data on the nursing workforce. The Community Initiative on Nursing, through the funding provided by the Robert Wood Johnson foundation, has collected random sample data since 1997 related to the supply of the nursing workforce. However, there is no population based data available to date on the supply of nurses in Hawai’i. In May 2007, a population based registered nurse workforce survey was conducted coinciding with the Board of Nursing Registered Nurse relicensure to assist in the identification of nursing needs, establish data initiatives, and inform policy makers concerning the nursing supply in the State of Hawaii.

Methodology
A survey of all licensed Registered Nurses is being conducted throughout the State of Hawaii to examine registered nursing supply. All RNs in the State of Hawaii were sent a survey that coincides with the Board of Nursing relicensure. RNs were mailed the survey questionnaire accompanied by a letter explaining the nature of the survey and an invitation to participate in completing the survey questionnaire. Enclosed in the package was a return self-addressed postage paid envelope for ease of return. The survey information also identified that participants could choose to complete the survey online at the BON relicensure site.

Analysis
Descriptive statistics will be used to examine trends in the demographic distribution of registered nurses (i.e., age, gender, and ethnicity), education (i.e., RN, APRN), employment (i.e., acute care, long term care, home& hospice care, etc.). Factors such as number of hours worked per week, intention to leave employer, and reasons for turnover will be examined. Distribution of nurses employed across healthcare settings (e.g., acute care) will also be identified and described. Factors known to have a significant impact on the growing shortage such as anticipated retirement and migration out of the state will be examined.

Results

Survey results will be reported to State government and stakeholders in healthcare. The report will also be made available on the Hawaii State Center for Nursing’s website on completion of the study.

HAWAI’I PARTNERS IN NURSING
ADDRESSING RECRUITMENT AND RETENTION IN LONG TERM CARE

The Hawai’i Partners in Nursing (HPIN) project is funded by the Robert Wood Johnson Foundation in collaboration with the Northwest Health Foundation and is a partnership between the HMSA Foundation and the Hawai’i State Center for Nursing.

The project has brought together partners from education and practice (academic sites paired with long term care facilities) to develop and implement an integrated model of education and practice in long term care.  The partners include:  The University of Hawai’i School of Nursing and Dental Hygiene with Maunalani Nursing and Rehabilitation Center; Hawaii Pacific University with the Hi’olani Care Center at Kahalu Nui; Kapiolani Community College with Leahi Hospital and Maui Community College with Hale Makua.   The first project year has been completed and much has been accomplished.

The first arm of the demonstration project involves nursing student clinical placement in each of four LTC facilities in partnership with a school of nursing.  The first two clinical rotations have been completed by all four partners.  Nursing students in their initial fundamentals course have been introduced to long term care and to the specialty of geriatric nursing.  The third rotation is scheduled to begin in Fall, 2007.  Students, staff, residents and families have expressed positive feedback about this experience.  The third rotation is scheduled to begin in Fall, 2007.

The second arm of the project involves faculty from the schools of nursing providing in-service education or clinical skill upgrades to the staff of the LTC facilities.  Inservice education has been provided by all four partners and has been met with enthusiasm and appreciation.  Specific areas of focus, as identified by MDS quality data, have allowed each long term care facility to meet the needs of staff and residents.

The third arm of the project involves preceptor training which was developed in collaboration with the long term care partners by Lois Greenwood, PhD from VITEC at Maui Community College.  Twelve registered nurses completed 40 hours of preceptor education to become certified trainers.  They demonstrated commitment, dedication and hard work…a most impressive accomplishment!   The certified trainers are now holding classes for preceptors in their respective facilities. 

Evaluation of the project will enable us to identify best practices and to make our results available to influence education, practice and local policy development.  In addition, we hope to encourage sustainable change within each facility and within each school of nursing.

The project is moving into the second year with excitement and enthusiasm on the part of all the partners.  Each of our partners deserves a big MAHALO for their tremendous effort to embrace and implement innovation and change.  Their pioneering efforts will result in benefits for nursing and health care delivery in Hawai’i!

FROM THE EXECUTIVE DIRECTOR

2007 has been an exciting year for nursing in Hawai’i.  The 2007 legislative session brought strong support to increase educational capacity in all our public nursing programs.  Funding was allocated for faculty salaries, infrastructure, physical facilities and interdisciplinary training.  Many nurses from throughout the state involved themselves in the legislative process and assisted in educating our legislators about the nursing shortage and about the significance of the nursing profession to the health care of our population.  Faculty and students were also part of a strong presence at the legislature.  MAHALO to everyone who was involved…you make a difference!

The Center was an active participant in the 5th Annual Conference of State Nursing Workforce Centers, “Taking the Long View”.  We were honored to be part of a distinguished group of nursing leaders and presented our HPIN project on two panels and a poster session.

The Center has many ongoing projects including the five year survey of new graduate registered nurses, the annual educational capacity survey, a survey on reasons for turnover of registered nurses and a demand survey from health care organizations in our state. 

During the remainder of 2007, we will hold a strategic planning day for our Center and a SUMMIT to develop a long range plan for the nursing workforce.  Hold the dates of DECEMBER 6 AND 7!!

The Center owes a debt of gratitude to the many nurses who contribute their time, energy and expertise to our projects and initiatives and to all of you who make a difference every day!

Barbara P. Mathews, MS, APRN, CNAA
Executive Director

Hawaii State Center for Nursing