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Mandatory/Required Workgroup
Workgroup members Cheryl Lovlien, NES Supervisor LeAnn M. Johnson, Nurse Administrator Lynn Alcock, NES Educational Technology Kathy Ferguson, NES Competency Program Karen Sell, HR Service Partner Heath Elenbaas, University of Minnesota, Graduate Student
Identification of Issues
Charge from Nurse Executive Committee (NEC) to define “mandatory” “required” implications when requested by proponents of initiatives.
Implications: Compliance & tracking Burden in time and effort Outcomes
Identified Process
1. Preliminary review of issues
2. Focus Groups to collect data
3. Complete data collection and develop themes to represent Focus Group conversations.
4. Review of literature
5. Benchmark
6. Develop recommendations
7. Present project and recommendations to NEC
8. Develop plan based on support of Nursing Leadership
9. Communicate
Review of issues
No clear definition of Mandatory/Required training No clear process of approval, review of cost/benefit or
related outcomes Concerns with amount of education and staff feeling of
continuous amounts of mandatory training No way to identify what training meets which criteria for
accrediting agencies (Joint Commission, Magnet, ANCC provider)
Event related to lack of tracking BLS/ACLS Magnet requests for data-difficult and time to collect
information Dissatisfaction from learners who do not feel required
training is appropriate for their role
Draft Definitions
Education: transmission of vocational/professional knowledge, skills and abilities to provide safe, competent care and/or ability to function within the employee’s role in the organization.
Information: Content specific to the employees ability to perform job functions: changes in policies, procedures, equipment, new and changed processes. Need to determine what information is “required” to perform job function
Communication: Content that is beneficial (would make work easier) but not “critical” to patient safety.
Draft Definitions Mandatory training: required by law or governing agency/legal
statute (ERTKA, OSHA, HIPAA). Implies tracking of compliance
Required training-education: Mayo Clinic or we as a division/department in the health care organization deem this information to be “required”. Implies tracking of compliance
Recommended: Does not require 100% individual interaction with education. Conceptually 60-70% spread of information can influence change. No tracking for compliance
Training: “to teach so as to make fit, qualified, or proficient” Merriam-Webster (m-w.com)
Focus Group
Requested time at unit meetings to hear from the “end user/customer” (unit councils, staff development, preceptor, practice, congress) Attended 43 different groups, > 347 nursing staff
participated
Request for centrally located Focus Groups to hear the voice of Leadership (Nurse Manager/Nurse Supervisor/CNS/NES) and concerns with current systems/processes. (4, one hour sessions across campus sites) 75 nurse leaders participated
Face to Face Education- Nursing Staff
When it makes sense: Hands on required (decubitus ulcer, insulin pen)-
connects information to action Important knowledge with rationale (sepsis-diabetes)
Difficult to attend PIE: Practice Initiatives Education – parking, can’t get
away during work hours to attend, staff don’t support
Allow staff input to Education Determining topics, determining assignments Disseminating education/information Superuser/Champion models
Online Learning-Content- Nursing Staff
Methodology: When it makes sense (fire, safety, code 45) Issues:
Too many-OVERWHELMING-“Death by Powerpoint” Need to know how many slides/how long The assignments need to fit my job responsibilities Allow me to test out if content repeats the same year to year Can’t receive immediate feedback
What would they like to see: Multiple options (face-face, online, interactive options, ability to test out)
Method fits the content If testing, do small content, then test, more content then test Provide with immediate feedback if answers wrong
Online Learning with Sound- Nursing Staff
Can’t do on unit computers (sound not active, too noisy in area, not available)
Culture: not supported, viewed as “goofing off” Can’t do during work time: “I’m here for my patients”
Liked RRT Video/sound functionality
Can’t bookmark Can’t move ahead
Online Learning-Navigation- Nursing Staff
Easy to use: “personal view”, “one stop shop” for all online training, automatically goes to transcript
Testing: give me rationale as to why I missed the answer (immediate feedback)
Navigation Buttons: Keep in the same place on all training
Auto bookmark: “instead of losing my place when I can’t get back to the screen before it shuts down-have to re-do all content”
Notifications: like them, but in just the right amount-enough to remind me without NAGGING
Retrieving Information later: right now when education is done there is no where to get it unless there is a guideline
Online Learning-Time- Nursing Staff
Control timing of assignments Too many--“You think you’re done and then another
note arrives” BATCH Quarterly (33 of 43 groups recommended)
Provide time (away from direct care)/coverage: Need uninterrupted time
Hard to concentrate, distracting on the unit with noises, alarms, patient/family requests, can’t remember content, not a good learning environment
Access from Home- Nursing Staff
Yes: 53% Rationale: quiet, can concentrate, can pay
attention, access to computers at work, would like option
No: 47% Rationale: want to keep work life balance,
don’t want to HAVE to do it at home Discuss info with colleagues in the moment
Competencies- Nursing Staff
Emergency Medical Response- Why the same every year Want a “bus stop” on unit to complete
No Paper Competencies Complete online “Who reads these?”
Centralize all our competencies: “one stop shop” and Decentralize bring it to me
Rationale: why are we doing the same thing year by year
Focus Group-Themes- Nursing Leadership
One stop shop Easy to find
Reports Should come to me (push vs pull) Alert me to staff who need to complete Should be available by topic Do I have to track compliance on all?
If staff are off for FMLA, doesn’t look like we have compliance.
Focus Group- Nursing Leadership
Leadership involvement in assignments Consistent process to assign “required”
Identify criteria and categories (Category I, II, III topics)
Who determines the topics? Do we have logic (rationale) behind these
decisions? “Just because of one event, one year, we keep doing yearly”.
Focus Group- Nursing Leadership
PIE: concern with ongoing access to content, ability for staff to access
Need time: but how does it get used, who tracks, what if they don’t need time?
Need multiple options to learn, find the best methodology
Competence assessment: what has to be done? What is required? Who determines the need for the topics and who does them, What is the best practice?
Access from Home- Nursing Leadership
Large Majority: NO Need to track time: which would be difficult
don’t have a mechanism, would require more time from Leadership/emulator
Mixed Message: “we’re telling them they shouldn’t be connecting to work from home and then we allow it”
Would not be Fair/Equitable: Some work to get it done as soon as possible, others take all the time given
Benchmarking
No definition: use Mandatory/Required interchangeably
Provision of time: ranges from 0-100 minutes/quarter.
LMS: all use some type of system
Access from Home: most do not due to FSLA, those that do provide for Contact Hour
Topics: determined usually by one person or a committee.
Allina Hospitals & Clinics, Cleveland Clinic, Johns Hopkins Hospital, Mayo Clinic in Florida, Shasta Healthcare
Next Steps
• Present project and recommendations to NEC• Next week- Nursing Informatics Technology Committee
(NITC) to discuss proposal for LMS• Develop plan based on support of Nursing Leadership
• Tiering Education Workgroup begun to look at approval process and methods for Mandatory/required education.
• EPD Technology Workgroup: reviewed Literature on how to select an LMS, created LMS requirements document.
• Communicate
Coordinate with other groups: • Night owl education workgroup
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