One way that we support ourselves in our practice and expose ourselves to new ideas and best practice updates is by attending professional conferences. On October 30th November 1, the ANCC held their 2024MagnetandPathwaytoExcellenceConferencein New Orleans, LA. Carilion Clinic supported representation by sending 24 nurses to attend and celebrate our 5th magnet designation. In this special conference edition, we will share some of their notes and takeaways from the sessions they attended. Feel free to reach out to these attendees if you see something of interest in their commentary!
On November 21, we welcomed the return of our live NursingResearchConference:SparkingInnovation&EngagementinNursingResearchandEBPat CRMH! Nurses and other healthcare professionals shared in a day full of internal dissemination, information, and dialogue. From the keynote by Dr. Kim Carter (NursingResearch&EBPatCarilion:ItOnlyTakesaSpark), to the presentations by our partners in Research & Development and the IRB. Attendees provided wonderful positive feedback and reported feeling more confident in participation in EBP and research after having attended.
We wish to remind you that Within REACH submissions are accepted on a rolling basis and that we accept stories and articles related to article critiques, human interest stories, literature reviews, evidence analysis, research, quality improvement, and proposed state or national legislation. Essentially, any story that aligns with our REACH professional model of practice is appropriate for peer review and publication. We would especially like to hear from those of you who have a potential Magnet story for our next certification! We want to share all of the good work you do for your patients and colleagues. By publishing in Within REACH, we have a recorded source of studies with outcomes and contact information and there is the potential to collect other stories for our next Magnet survey! Publishing in the Within REACH may also be an option for the CAP program.
Magnet Conference Takeaways
Reviewers
CarilionNursingResearchEditorialBoard:
Chris Fish-Huson, PhD, RN, CNE - Editor-in-Chief
Nancy Altice, DNP, RN, CCNS, ACNS-BC
Desiree Beasley, MSN, RN, CCNS, CCRN
Sarah Browning, DNP, RN-BC
Charles Bullins, DNP, RN, AGACNPBC
Sarah Dooley, MPH, BSN, RN
Troy Evans, MSN, RN, CCRN, NHDP -BC, NEA-BC
Cindy W. Hodges, MSN, RNBC, FCN
James Ingrassia, MSN, RN
Lauren Miley, BSN, RN, PCCN
Laura Reiter, DNP, RN, CCRN, CNRN
Cindy Ward, DNP, APRN-CNS, RN-BC, CMSRN, ACNS-BC
Magnet Conference Impressions—Cindy Akers
Sessions Attended:
Optimizing Sitter Use– Enhancing Safety and Cutting Cost
Partners in Care– An Innovative Team Nursing Care Model
Meaningful Recognition– Transforming Healthcare Work Environment
Applying Lessons to the Workplace:
Sitter presentation: We currently have a verbal discussion of sitter justification, but would use of a needs assessment checklist help decrease unnecessary sitter use?
Workplace violence: We are currently utilizing DASA tool (like Brosets) on 9MPCU, there is a need to roll this out to roll this out to other areas. Can we also apply specific orders to help premanage aggression? Would Broset’s also be a good option to use?
Partners in Care: We are doing some of the things presented (use of Mobility Techs), LPNs. We currently have had issues hiring PCTs that could be a barrier. The facility presenting spoke to not having high PCT turnover.
Meaningful Recognition: Would like to establish a Recognition Toolbox to use throughout the system for recognitions.
Lessons Learned/Takeaway:
Use of a sitter justification form and pt behaviors tool helped to fine tune sitter needs.
Use of Broset Violence Checklist (BVC) to determine needs to put in place if patient is high.
Pairing up PCT’s with nursing staff helped create a more team-based approach to patient care.
Establishing a Recognition Toolbox to standardize the way we recognize could help enhance and ensure that recognition programs exist in all areas.
Magnet Conference Impressions– Sara Grimsley
Magnet Conference Impressions– Sara Grimsley
Sessions Attended:
M505 Supporting the Future Student Nurse Transition Support
M527 Magnet Application Manual Hot Topics
M626 Savoring Data: Journey through Magnet Data Presentation
M635 Creating A Magnet Program Director Boot Camp
M650 Partners in Care: Innovative Team Nursing Care Model
P658 One Unit’s Journey From Being in the Flames to Being in the Fire
M723 Innovation in Nursing Education Using Data Analytics
Applying Lessons to the Workplace:
Addressing RN Workplace Violence
• Implement unit-based workplace violence prevention initiative to improve workplace safety for nursing staff.
• S-M-A-R-T Goal: 100% RN participation in de-escalation training (already offered by Carilion) within 1-year of hire.
• Advocate for real-time reporting tools for accurate data collection on violence events towards RNs to identify trends and risk factors and influence workplace safety outcomes.
Increasing RN Engagement
• Bedside nurses trend/evaluate employee engagement data to identify unit goals/opportunities for improvement.
• Foster open communication channels top-down & bottom-up
• Build a culture of transparency and accountability.
Stoplight Report
"My Unit My Practice" bulletin board
Address nurse concerns proactively
Perform "pulses" surveys in between Employee Engagement annual survey
AI, Virtual Nursing: Leveraging new technologies to decrease nursing documentation burden and improve workflow
• Assess, Plan, Implement, and Evaluate integrating AI & virtual nursing informatics tools ASAP the evidence is there, the results are real
Integrate virtual nursing and AI-driven tools on PHI-secure platforms for administrative plus documentation tasks
Promoting Transformational Leadership at the Bedside
• Leadership skills trainings for bedside nurses
Leadership Conference
HR education
Leadership Institute programs
Magnet Conference Impressions (continued)– Sara Grimsley
• Succession planning: identify individual RN's strengths/interests then target professional development vs "What does organization need? What positions are open or opening?"
• Impact: 1) Drives unit-level Innovation 2) Improves team collaboration 3) Enhances care delivery outcomes.
Patient Satisfaction/PX: Major Focus of New Magnet Manual Updates
• Improve HCAHPS scores (i.e. % LTR) utilizing data-driven strategies and AI (see bullet point 3) to identify patient care gaps & implement personalized care initiatives to exceed patient expectations, LT.
"Distinct "Data Collection Pathways" Required for Accurate Data Collection
• Insight from 7 Mountain Medical Cardiology PCU: “Bedside RNs engaged as Quality Champions for unit/dept/organizational scorecard measures/goals & PI projects has been a Critical Gamechanger on 7MPCU and was key catalyst in our journey to Beacon. Staff RNs use Cipher digital rounding technology for Pre- & Post- Data Collection to measure & evaluate all the work we are doing and use Cipher as a distinct data collection pathway to assess, trend, and evaluate our compliance with nursing process measures and patient care prevention bundles. Monitoring process measure compliance provides valuable data to evaluate overall outcome performance against and identify opportunities for continuous improvement. Engaging bedside RNs in unit-based data collection optimized by cloud-based mobile informatics like Cipher helped drive positive changes our unit Culture, Team, & Outcomes.”
Magnet Conference Impressions- Rachel Altizer
Sessions Attended: M150 Creating a home for APRNs
M620 Implementing Nurse Led Workplace Mitigation Improves Safety
M523 Career Development is the New Succession Planning
Applying Lessons to the Workplace:
I did see Carilion is actively doing a lot of things that other facilities were presenting. I would enjoy working with someone for us to present the more novel work we are doing with the 2 RN Assessment/Scribe project to present at the next Magnet conference.
More robust succession planning
How can we entice people to stay here? How can we show them we value them and their professional growth/keep them with us?
I would like to see more conversation about creating a ‘home’ for APRNs . Currently, they are between bedside staff and physicians. How can we make them feel more at home?
Lessons Learned/Takeaways:
As a system, we are already doing a lot of things other facilities are doing seeing this, I would love to encourage our staff to put themselves out there and present their work at these conferences.
APRNs reporting to other APRNs currently they are department specific or under a senior leader (unsure)?
As I am finishing CNS school, I attend two APRN sessions/one about succession planning. I would love to see a more robust succession planning for our people that are staying within the system i.e. bedside RN to APRN role.
Magnet Conference Impressions– Jennifer Martin
Sessions Attended:
M511 Navigating the Emerging Future
M527 2023 Magnet Manual-Hot Topics
M607 A Dual Strategy
M618 Virtual Vigilance Supporting bedside through virtual appraiser meeting
M718 Succession Planning
Applying Lessons to the Workplace:
Sharing what others are doing with virtual care (with in room cameras and mobile iPads)
Implement downtime practice session/events (tabletop and more in depth), develop quick reference guides on basic care workflows for all care provider roles (orders writing, transcribing, communicating to intended department, etc.; required documentation during and after event; tracking and patient movement; paper documents’ organization for extended event)
Educate on Carilion’s succession planning practice and evaluate does this meet nursing’s needs.
Lessons Learned/Takeaways:
More downtime unplanned events should be anticipated (cyber threats and weather related).
AI– Augmented Intelligence –the need for nurses to understand the differences in types of AI and the required human interactions/decisions.
Virtual Care continues to grow and evolve. Organizations adding virtual team care into simulation learning for staff to gain some comfort with virtual care teams.
Succession planning –targeted fellowships (research, education or leadership –not a specific job title). Research track removed with review of program. Eligibility requirements (applicant and mentors), structured project documentation/presentation. Templated documentation of development planning, etc. Project topic assigned by nursing leadership. Requirements for mentor training.
Sessions Attended:
Neuro Clue
Immersive Learning
VR/AI Vendor Nurse Residency
Applying Lessons to the Workplace:
VR/AI incorporated into nurse residency for engaging learner experiences for clinical judgement and critical thinking which is currently not well taught or assessed.
Establish outcomes and begin writing up the projects wea are doing here at Carilion because we are doing big things!
Lessons Learned/Takeaways:
Lots of ideas to create fun ways to learn. There is an opportunity for us to create gamification to make learning fun in Nurse Residency.
Have already had a demo presented to us on the utilization of VR and AI technology on clinical judgement and critical thinking. Plan to present benefits to senior leadership for incorporating this into orientation and residency.
We are ahead of the game with nurse residency and many organizations are following the footprint we have already completed.
Sessions Attended:
Magnet Conference Impressions– Celeste
Fisher
M506 Adopting 4M Model for Age Friendly System
M523 Career Development Planning is the New Succession Planning
M523 Succession planning focuses on the role, not the individual. Development planning identifies a person’s interests and goals, ensuring the right opportunities, whether within or outside their department..
M510 APRNs bridge nursing and provide roles, often feeling “othered.” A structure that acknowledges their dual scope and influence in both nursing and medical models fosters belonging.
P645 Ascension Seton in Austin evolved their extern program into an ‘earn-while-you-learn’ model, allowing students to earn clinical hours while working with a nurse preceptor. Contracts with nursing schools and state legislation were needed to allow paid student employees to complete clinical hours.
M608 Nurse Leader Roles in 2024: Quantitative and Qualitative Shift
M617 Decreasing Nurse Turnover An Innovative Approach
Applying Lessons to the Workplace:
Certification Study Group: I don’t know where we stand with leadership certifications, but this is a great way to promote growth and work together in preparing and studying. We did this with the NE -BC/NEA-BC and I am wondering what our pass rate was? We used an external organization to run that study group though.
RN Ambassador Program: Would love to work on this in the Culture Committee. Get backing from the organization o start with a few positions and gather interest from experienced staff. Come up wit new, dynamic ideas and events that feature the ambassadors and engage applicants.
Nurse Leader Roles in 2024: Quantitative and Qualitative shift: We do a lot of this work within ILE. I think we would benefit from having position or 2 who are effective nurse leaders who can work with those who are tackling challenges. This work could be done on consistent, daily basis. Help them to work through their challenges or their top 3 areas for improvement and monitor change and metrics on the units.
M617: Decreasing Nurse Turnover– An Innovative Approach: this reminded me of a few things we’ve developed within Carilion-moral distress consults and code lavender. I think it would be beneficial to have a more proactive approach to managing employee stressors and having a real-time assessment of those who may need support in the moment.
Lessons Learned/Takeaways:
P642 Encouraging more certification of nurse leaders. They collaborated together and worked through a virtual study group in order to study and prepare for their exams.
M521 Loved this program! Utilization of bedside nurses to connect with students/interested applicants. They are part of recruitment and stay with those nurses and serve as mentors if they are hired on in the facility. Increased engagement, reduced turnover, and increased retention!
M608 This seemed very similar to our leadership sessions taught at Carilion through ILE. Invigorate and Peaks are both development programs for leaders that follow similar models. Would love to see more mentorship for leaders to help address needs on their units.
M617 Implementation of the SERA (resiliency advocate) position in place to know staff, respond to traumatic or stressful events, monitor staff for distress and be proactive in taking care of each other. Utilized relational rounding and stress first aid.
Magnet
Conference Impressions Stephanie Defilippis
Sessions Attended:
Emphasis on professional boundaries
Acuity based model infusion center ambulatory
New verses seasoned nurse leaders
Preceptor prep rallies
Boosting Med adherence elderly population
Applying Lessons to the Workplace:
• An acuity tool could be made to help staff infusion center with ample nurses to help increase satisfaction
• Preceptor prep rally, I believe, we are already doing with preceptor pearls
• Education on how crossing professional boundaries with coworkers and with patients/family members can hurt coworkers and the unit fluidity
Lessons Learned/Takeaways:
Professional boundaries between patients and nurses are important and can affect coworkers (social media friends etc.)
Acuity tool based on medications and chair time to be used to figure out nurse ratio in the Infusion clinic
Inclusion into the organization is a choice but belonging is a feeling
Factors to take into consideration for adherence; mentation, mobility, and type of medication.
Magnet
Sessions Attended:
M518 Caregiver boundaries and burnout: Do friends steal your joy?
M617 Decreasing Nurse Turnover, an Innovative Approach
M634 Shining a spotlight on early deterioration: The STAR Nurse
M653 Preceptor prep rallies: Empowering preceptors by going back to basics
Applying Lessons to the Workplace:
Friend Burnout– discussion about maintaining professional, and more importantly, healthy boundaries with sick patients and holding each other accountable for the gray areas. Encouraging others to speak up when they recognize coworkers may be overstepping into patient’s personal life or over-engaging. I plan on discussing this openly specifically to the PICU– is it a moral and professional responsibility? Emotional maturity? Should there be a policy about following patients on social media? Who would enforce it and gauge compliance?
The STAR RN: after attending this session, I was happy to think about how CRMH already has amazing resources like a Rapid Response Team and Clinical Admin– specifically for Pediatrics and NICU through– we heavily utilize the Neo/Peds Transport team (if they are in house) in emergencies and for transport of young patients to scans etc since IH transport doesn't transport children. We do most times use our CTLs and experienced RNs as the “float charge RN” who ONLY floats between the Peds ward and PICU their whole shift as expertise and helping hands. Pediatrics/PICU charge RNs and CTLs have met to try to define the roles of the ’float’ charge nurse before, similar the role of the presented “STAR” nurse, but also different. This is something we continue to work on, and I could see being VERY beneficial to the adult floors, too!
Preceptor Prep Rallies: having DESIGNATED bedside staff RN preceptors on each unit and training them specifically for training and educating new hires day to day would be very helpful for retention I would think. In the past I have been confronted on a whim by managers, or not even told at all that I would have a new hire orienting with me for my shift. From experience this is NOT optimal for new grads’ learning and also precipitates exhaustion and stress for current staff.
Lessons Learned/Takeaways:
M518 This was the most, personal, meaningful and interesting session to me from the whole conference. Most of the attendees were RNs that work with children, neonates and oncology patients, or worked in patient’s homes; patients that they encounter often and for long periods. Topics were covered about the negative impacts of the gray areas we encounter with our patients when we “overstep” our professional boundaries and go seemingly, “above and beyond” and how the hospital environment has actually perpetuated a culture of recognizing and even rewarding his behavior. Speaker also discussed the negative emotional and moral distress that comes with accepting/extending friend requests from patients/patient’s family members on social media. Also covered the pros and cons and ways to navigate the “super nurse” or “primary nurse” culture in places
Magnet Conference Impressions (continued)- Madison Brown
nationwide such as the NICU. This session helped me realize that feelings me and my coworkers experience are not isolated feelings.
M617 Here, it was discussed how one hospital implemented a moral distress team in their EDs and ICU environments where they statistically had the most reported “burnout and stress”. The team was made of trained individuals in counseling, psychiatry and emotional trauma. They were also employed by the hospital full time, 24/7. Instead of waiting for a code blue, or a trauma alert or debriefs held by MDs and RNs, they LEAD the debriefs and they rounded multiple times a day, every da and actively sought out staff and did frequent check ins. This increased staff emotional well-being, reportedly by survey, while at work, and also was a positive influence on retention in the years after the team was started.
M634 This hospital implemented a “rapid response nurse” of sorts, that had the sole job of checking on patients (in person) that triggered sepsis alerts, abnormal vital signs, or that triggered a higher Rothman Index score. This was an RN with ICU or advanced care pathways experience, and he or she would carry a red backpack with some emergency supplies to be the first to help with rapid responses or Code Blues. The STAR RN could help smoothly escalate care or catch near misses and intervene to prevent patient deterioration.
M653 In this session, one hospital implemented a “curriculum” for RN preceptors training new grads and new staff called “Preceptor Prep Rallies”. All of the preceptors would meet once a month in person as a group and check in and collaborate on which teaching and learning experiences have been beneficial/nonbeneficial to new hires. The preceptors also actively help to create new employees schedules and learning curriculum.
Sessions Attended:
P515 Let’s Get Loud: A talk series to build exceptional nurses
M526 Professional Architecture: What is certification and how is it a framework for lifelong learning?
M621 Predicting Patient Risk of Falling Using Artificial Intelligence
M653 Preceptor Prep Rallies: Empowering Preceptors b Going Back to Basics
M720 Decreasing Patient Mortality with Deterioration Index
Applying Lessons to the Workplace:
M526 Enjoyed the certification talk and included becoming certified as my goal for the fiscal year. Was assisted in finding the submission for the course and test voucher.
M653 Taking from the Preceptor Prep Rally, 8SPCU has decided to do something similarly to increase preceptor engagement and ensure that everyone is on the same page for training new employees. We felt that a lot of things are slipping through the cracks with new employees and if there ae trends on what that is, it could be related to your preceptors and not the new nurse.
M709 Engaging unlicensed personnel was interesting to me as I know our unit puts a lot of expectations on our PCTs but not sure if they feel the same support as the nurses do. Our PCTs talk a lot about the things they would like to change but it could be nice to create a PCT led shared governance committee on our unit to increase their satisfaction. I think it starts with also engaging a nurse led shared governance if our unit really wants staff led change. Helped me to get several ideas on how to implement that.
M720 Utilizing a deterioration risk score (Rothman) more formally on our unit to ensure best practice and timely care for patients. Provider notification of this score helps to ensure that nurse’s concerns are taken seriously if you have the data to back it up as well.
Lessons Learned/Takeaways:
P515 Nurse residency program that was implemented to decrease turnover rate and increase satisfaction (which include LPNs as well). Emphasized engagement and multiple ways to include the attendees. All the information was included in the first sessions and the last 6 months of residency could be focused on skills and projects . Gave space for new grads to be vulnerable once one person shared, others were more willing.
M526 Went over who is eligible to test, what the actual test include, and then how to get recertified emphasized that certification is a lifelong journey. Was a good mix of those who are looking to be certified and those who oversee helping nurses to get certified and how you incentivize it.
Magnet Conference Impressions
Went over a plan to seek a mentor, join professional association, communicate with employer, and take the rest encourage a 6-month study plan.
M621 Included the Fall Predictive Analytics Tool pulls info from flowsheets, medications from MAR, vitals, labs, etc. to generate a score of low, medium, or high and displays the score on the patient storyboard, brain, and several other places. Includes more information than just the Morse Fall Score and doesn’t have as much variability from different nurses.
M653 Focused on getting the preceptors excited and ready to train new grads/ new employees to decrease the amount of “things falling through the cracks”. Helped to get all the preceptors on the same page about how to teach skills according to policy. At the meeting (which took place usually before large amounts of new grads were starting), they had each preceptor take a topic they felt was most important and teach it to the group. Emphasized professional development with each preceptor. During orientation phase, they included bi-weekly meetings with the new member, preceptor, and manager away from the unit.
M709 Most organizations have extremely high PCT turnover rate created a PCT led forum for change. Implemented career ladder for PCTs with different skills on each level, held skills fair that was PCTs teaching PCTs on topics tat were requested. Included a PCT led shared governance committee instead of it being nurse led. All PCTs went through a residency as well with the Lead PCT running the show. One thing that stood out too was their emphasis on ensuring that nurses were educated on skills as well, so they weren’t relying too heavily on PCTs.
M720 Created an algorithm that had 17 factors built in to designate risk of deterioration in patients on a PCU and was built into Epic that updated every 15 minutes. Color coded low, medium, or high was shown on patient’s storyboard and high risk alerted as a BPA. Providers were given same notification as nurses. Helped to increase number of planned ICU upgrades instead of emergency upgrades. Specified high-risk patients as “watchers” and everyone on unit was aware of them (emphasized in their shift huddles) as well as providers and their version of clinical admin.
Magnet Conference Impressions– Brittany Hendricks
Sessions Attended:
P515 Lets Get Loud: A Talk Series to Build Exceptional Nurses
M519 Emotional Wellbeing– Supporting Our team Members
M633 Empowering Nurses with Resources
M647 Transforming Safety Culture through Staff Empowerment
P714 Night Shift “Fall-Back”: Improving Well-Being and Engagement
M719 The Ultimate Authority Nurse Executive Council
Applying Lessons to the Workplace:
M519 I loved the ideas they gave in this session for our Recognition Council. Their Recognition Council was called Nurse Wellness & Recognition Council, which I thought was a great way to increase how we think about and address nurse wellness more consistently hospital wide. I thought their Tea for the Soul, Sacred Pause, and Moment of Mindfulness were particularly insightful. Moment of Mindfulness happened x2 a week at their daily huddle, it was performed by one of their chaplains where they read a poem from a range of spiritual disciplines with the intent to help ground them for the day. Tea for the soul, is similar to something we already do at Carilion, but it can be set up in advance by the UDs for the units to provide physical, emotional, and spiritual refreshment for their teams.
P714 I think the Fall-Back night would go a long toward reaching out and helping our night shift team feel more included. I loved that this would be something just for night shift, to help them feel like they aren’t just getting the dayshifts left over education. This is something I’d like to start doing on my unit next year. I think this could be implemented hospital wide with the right buy in.
M719 Seeing the way this hospital overhauled their shared governance structure and supported those in shared governance was particularly enlightening as we try to overhaul our own shared governance. I like how everything was standardized across all councils, there was no give on this, each council did everything the same. Each chair was given a laptop and met for 6 months to learn the role of the chair and how to manage a council. They also standardized their timelines: odd years they hold elections for councils and provide membership training, even years they update any charters and the leadership training.
Lessons Learned/Takeaways:
P515 This was all about how to better engage our nurses during nurse residency sessions, however the information provided was applicable to all aspects of nursing education. It discussed Brain Based Theory and gave idea on how to be more creative and help our nurses form associations through actions and stories.
M519 This session discussed the 6 dimensions of well-being emotional, financial, intellectual, physical, social, spiritual and gave ideas on how to help fulfill these needs for our staff.
M633 They created an in-house CNA training program with the aid of their CNO, which not only filled their open roles, but also created their own pipeline of future RNs. They paid for all CNA training and paid them for their classroom time. This session also discussed a “Culture Club” to help facilitate a change in hospital culture by empowering our staff to make changes, starting with themselves.
M647 Be patient it takes time. Culture star of the week given to 1 nurse for exhibiting an attitude of positive workplace culture.
P714 This hospital helped improve nightshift engagement by creating a hospital “Fall-Back” fair. This is only for nightshift employees and happens every year on daylight savings time. Over 700 employees attend. Makes nightshift feel like something is happening just for them.
M719 This hospital overhauled their shared governance and standardized their structure . They use the same template for charters, agenda, attendance, etc. All meetings occur on the 1st Wednesday of the month, with an in-person meeting quarterly. They focus on EBP and recognition. The council chairs go through leadership training program and all council members take a 4-hour course once a year.
Sessions Attended:
P514 Improving Throughput: A Direct Care Nurse Team Solution
M518 Caregiver Boundaries and Burnout– Do Friends Steal your Joy?
P613 Transforming the Work Environment to Retain Nurse Leaders
M617 Decreasing Nurse Turnover: An Innovative Approach
M631 Implementing the Blue Dot Program for Vulnerable Populations in the ED
M653 Preceptor Prep Rallies: Empowering Preceptors by Going Back to Basics
P730 Mentoring for Success– Retaining New Nurses
Applying Lessons to the Workplace:
P514 Implementing a one-call attempt repot, eliminated “black-out” shift charge transfers and escalating a second attempt report to a CTL to CTL report drastically improves through-put for disposition to inpatient transfer, ultimately decreasing waiting room times, census and stress on staff. This in-turn improves patient safety and overall satisfaction.
M518 There is a direct correlation between nurses that do not have an established self-identified boundary vulnerability and increasing instances of secondary trauma, stress, turnover with no increase in overall satisfaction. Having marked boundaries with patient’s and patients families allows the nurse to provide safe, more compassionate care to all patients in question and ultimately increasing satisfaction in the work that they do.
M631 Implementing a blue-dot like system in the emergency department can greatly increase the chances of identifying at risk populations such as abuse and sex-trafficking. The mission of this organization is to better our overall local populations in every way, so if we are potentially able to save lives, I believe this is of paramount importance to bring to the organization.
M653 If there is a possibility at a departmental level, introduction of preceptor bootcamps would be monumental. This is critical as it not only creates a just culture in a department providing proper techniques, best practices and implementation of evidence-based research, but it also shows that nurses feel more welcome and respected during their orientations by preceptors that feel prepared and given the proper educational tools by their nurse leaders.
P730 Overall Carilion is doing exceptional at constructing a culture of excellence and mentorship. We have implemented a fantastic nurse residency program with close preceptor follow-ups on units. We should continue to strive towards educating new nurses on proper procedures.
Lessons Learned/Takeaways:
P514 During 2022-2023 due to increasing holds in the ER a critical access hospital’s ER implemented a one-call attempt report, eliminated “black-out” shift change transfers and escalated a second attempt report to a CTL-to-CTL report. From January 2023 through June 2024. They saw an almost 100% improvement in total Dispo-INPT bedtimes averaging a decrease from 61 minutes down to an average of 36 minutes, which is an incredible accomplishment.
M518 A study conducted of inpatient pediatric nurses showed that individuals that did not establish hard professional boundaries through family members in person, after shift and on Facebook increased risk for secondary trauma, and burnout. All while directly having no association with improved compassion satisfaction in the work that they do.
P613 A hospital shifted focus on protecting nurse leaders time spent at work. This change greatly impacted nursing turnover rates and overall satisfaction of floor nursing staff. Allowing the nurse leaders time to be properly allocated and used in less meetings, liquidating tasks and responsibilities to other nurse leaders, and decreasing 24/7 open door availability to more open-door accountability enables nurse leaders the time to give staff nursing the time planning and tools they need to succeed.
M617 The implementation of a Staff Engagement and Resiliency Advocate (SERA) that is dedicated to rounding on staff only, not as a patient advocate has proven greatly in reducing stress from work, aides in proper debriefing and processing of sentinel/traumatic events for staff and ultimately has improved workplace morale and a culture of positivity. Overall it has shown significant findings in nursing turnover in Salem’s report from over 16% in 2022 to 6.9% in 2024 estimating a savings of $2.5 million in turnover costs. At my current hospital we have rounding chaplains and a support structure group that we can voluntarily go to, but I feel that implementation of a SERA could be monumental for overall staff satisfaction and retention.
M631 Implementing a blue-dot like system in an emergency department can greatly increase the chances of identifying at risk populations such as abuse and sex-trafficking. In the past year, one hospital was able to identify 4 at risk persons, ultimately leading to one arrest. THIS IS INCREDIBLE!!!
M653 Implementing biannual to tri-annual preparation meetings for preceptors presenting reeducation of gaps in proper practices and procedures reinvigorate nursing preceptors and ultimately leads to overall staff satisfaction during orientation and overall retention.
P730 Overall implementation of a nurse residency program, provisional clinical education labs and a preceptor program on each unit has allowed organizations to shift culture from just education to a unit to overall mentoring new hires for success not only in their careers, but as individuals. I aim to move our culture at Carilion to broaden nursing overall knowledge base, improving utilization of evidence based research and overall linking. All while bonding new hires to seasoned nursing staff not due to common employer, but shared goals and governance.
Magnet Conference Impressions– Crystal Burton
Sessions Attended:
Improving Throughput: A Direct Care Nurse Team Solution
Emotional Well-Being: Supporting our Team Members
Culture-Club: A Framework for a Respectful Workplace
Transforming Safety Culture and Turnover Through Staff Empowerment
Preceptors: Going Back to the Basics
Nightshift Fall Back: Improving Wellbeing and Engagement
Mentoring Success
Applying Lessons to he Workplace:
Partnering with units across the facility to improve throughput with a combination of leader phone report and bedside handoff reduces unnecessary delays, peer to peer frustration, and improves satisfaction between staff, patients, families, and providers.
Mentor training programs and hospital based educators can greatly improve the communication of safety concerns, policy changes, process improvement initiatives, and development needs of staff.
The responsibility of culture of safety and positive practice environment cannot only rest with the formal leaders, empowering staff to take ownership and commit to doing their part is crucial
Magnet Conference Impressions
Lessons Learned/Takeaways:
Throughput improved using several techniques early rounding, shadowing between service lines for admission/discharge process., integration of designated admission/discharge staff, lead to basic report for ED to inpatient unit.
Integrating mindfulness moments after critical incident, high stress situation, or patient death can allow team to reset emotionally, mentally, and physically before returning to work.
Implementation of a Nurse Wellness and Recognition Council/Culture Club to promote a healthier practice environment to address overall holistic wellness, resiliency, and reduction of burnout and compassion fatigue.
Using teams of teams framework to improve safety culture while increasing empowerment and inclusivity by staff to collaboratively problem-solve while respecting each other and their leaders.
Basic foundational training for preceptors equips them with basic component needs for all care areas as well empowers them for early recognition of areas of concern, decreased competency, and/or further training/development needs.
Offering professional development opportunities, committee meetings, and engagement activities that are accessible to nightshift staff for in-person attendance will greatly improve team dynamics and inclusivity.
Establishing informal and formal mentoring process that extends beyond orientation and residency programs to improve retention, advancement, and satisfaction.
Magnet
Sessions Attended:
P515 Let’s Get Loud: A Talk Series to Build Exceptional Nurses
M519 Emotional Wellbeing-Supporting Our team Members
M639 Harnessing the Power of Story to Enhance Staff Well-Being
M647 Transforming Safety Culture Through Staff Empowerment
M705 Moral Injury, Moral Resilience, and the Work Environment in ICU Nurses
M719 The Ultimate Authority Nurse Executive Council
Applying Lessons to the Workplace:
M515 Loved the TED talk series they did for their nurse residents. CNO, ICU Nurses, and a member from ethics were brought to share their different stories. I also enjoyed the sessions were in person.
M519 I think our Professional Shared Governance could use a night shift council.. Also, I liked their Tea for the Soul rounding by leadership and chaplains. Brittany and I thought a ’Tea Brief’ would be fun to implement in the ICU after emergencies to debrief over tea with staff.
M705 This was an interesting study on moral injury and resilience. I think we could really look at how we educate our new nurses on ethics and ethics consults. Increased chaplain rounding for our night shift team seems like it would have some benefit on decreased stress and increased moral resilience!
M719 My favorite session was the executive council sessions. Recognition was a focus in ALL councils. They had a lot of structure in place: training for new chairs, new leadership training to increase staff empowerment and engagement, CNO quarterly attendance at executive council, as well as, alternating years for website/charter updates and membership training.
Lessons Learned/Takeaways:
Magnet Conference Impressions (continued)
P515 This session was about the structure of a nurse residency program. They front loaded leadership, professional development, and quality for the first 6 months. Then the last six months, they focused on clinical scholarship. They used brain-based learning principle where they helped their residents learn through paired senses such as stress ball activity for EAP resources. They had a TED Talk series where their CNO and other members of the hospital would come speak to residents. They also used a staff panel with different bias and experiences to answer questions during one of their sessions. All sessions were held in person to increase engagement.
M519 They shared a lot of examples of how they increased nurse well-being at their facility. Had their own nurse wellness and recognition council including healthy options for cafeteria at night and night shift supervisors. Tea for the Soul (rounding by managers and chaplains), Sacred Pause when one member reads a card on back of badge after patient passes.
M639 They brought “brain tattoos” to their facility where they would select nurses to share heir stories. “Tattoo” with a sharpie 1-2 words on their body, then partnered with their marketing team to share the nurse’s story.
M647 Used the book, TeamofTeamsto develop a model of staff/peer selected leader support. Used the analogy imagine the tip of the iceberg being the event and the iceberg being all of the issues to follow. Perception is reality.
M705 Moral resilience has an inverse relationship to moral injury. One third of nurses never had ethics education. Fifty percent called ethics consult but only one third participated. Forty-six percent of study participants were affected by morale injury with shame and guilt being key drivers. Being Magnet did not make a difference. (This was a multisided research study.) Increased chaplain support specifically on night shift boosted moral and decreased stress.
M719 New chairs had training for first six months (4 hour training session and then 1 hour monthly meeting with their program director). Goal planning for 4 hours once a year for all chairs. Odd years they did election timeline and membership training and even years they did charter and website updates. Recognition is a focus over ALL councils. CNO attends quarterly executive council meetings. Leadership training to ensure all leaders understand PSG to empower staff to participate.
