CSPCN: CBPPSIT Meeting

December 4th, 2001 (Ontario Hilton)

10:00AM – 3:00PM

 

MINUTES

Present: A.Sargent (asargent@samuelmerritt.edu), P.Walker (pwalker@acmedctr.org), C.Wraa (cheryl.wraa@ucdmc.ucdavis.edu), D.Welch (welchdi@earthlink.net), J.Harlow (jrharlow@quixnet.net), E.Lewis (elewis@uci.edu), P.Kliewer (pkliewer@valleychildrens.org), D.S.Moore (dianne.moore@scccd.com), P.DeLaCruz (pdelacruz@communitymedical.org), M.Raines (mraines@csusb.edu), G.Doxzon (gyd@redlandshospital.com), S.Keating (sbkeating@earthlink.net)

I. Meeting called to order by A. Sargent at 10:15. Introductions followed.

II. Report from Tri-partnership groups. Arlene and Polly discussed the background of the data collection process. Data collection was preceded by an evaluation of job descriptions of hospitals in California (D.Rutledge) which determined that a minority of hospitals have descriptions that indicate differentiated practice (especially those with a clinical ladder). Tri-partnerships selected if there existed: (1) hospital with "existing" differentiated practice (as evidenced by job descriptions) and (2) association with both AD and BSN education programs. Background written up and will be published in J Nsg Adm Q January 2002 (A.Sargent, S.Keating).

Tri-partnerships began January 2001, could collect data through December. Communication with Project Office and S.Keating (Project Director) through email, CSPCN website, and visits to sites by S. Keating. Data includes observations of student nurses and new graduates on medical-surgical units in patient care encounters. Much variability in observations (8 hours vs. brief; multiple observations over time; self-evaluations). Tool used based upon Competency-Based Differentiated Practice Model to measure novice/competent behaviors for two roles: teacher, leader, at two levels: care provider, care coordinator.

Data shown on 21 observations (1 time only) (actually 2 more available from Fresno - will be sent to D. Rutledge). Variability: students/graduates, 57% men, ethnic diversity. Findings: variability in competency with new graduates showing tendency to have more observed behaviors in competent "cell" and students tending to be in "novice" cell. For care coordinator, new graduates much more likely to have observed behaviors than students.

Group discussion - mushy data, yet tool useful for each site; sense that all want to go back and use some more. Qualitative data as important as quantitative (e.g., students missed patient cues for educational deficits). P.Kliewer (Fresno) actually proposed and collected participant observer data (field notes) and will compile this (some presented at Healing Web with S.Keating). Problems encountered: IRB approval delayed data collection, students hesitant to be observed (sign consent form), timing of observers hard to schedule. The "toolkit" provided was difficult to interpret for some sites - no real "orientation" was given due to lack of funds. The tool developed was not "intuitively" easy to understand. Interpretation of "common" on tool may vary from unit to unit; having all observations on one unit may help this. Timing of observations may affect outcomes (e.g., students only on units in a.m., discharges occur in p.m.; thus, many behaviors that related to discharge not observable). Small numbers of AD/BSN students make comparisons inappropriate at this point.

Does the model work? We can't say it "works," but it may be useful for practice/education settings to use parts of it in evaluating student/nurse behaviors, or in thinking about role expectations and preparation for these. Even based upon these meager findings, much discussion about how we can help students/nurses drvelop competence in these two roles (teacher, leader):

Work/study programs, internships, altered curricula…. Need to think about whether care coordinator is an expectation of students… in certain settings (critical care, or primary care systems).

Discussion of new model at Sacramento (Sac City/CSU): students enroll in AD program and concurrently take BSN classes; graduate in 4 1/2 years. To compare these grads (10 in first class) with generic AD and generic BSN.

III. CSPCN Project Director's Report (E.Lewis): Attached. Next CIC RWJF visit May 8, 9, 2002 (note this has changed after IOC meeting on 12/5/01; will be March 12-14 to coincide with turning over CSPCN roles to new BRN Advisory Committee). Discussion of newly approved Advisory Committee for BRN (J. Harlow).

IV. Finalize Data for Summit panel

V. Next steps: Where do we go from here?

Discussion of funding needs if project to go into beta phase. D.Jones getting incorporation papers for the Institute. Funding from health care systems, Division of Nursing, etc. Long-range - desire to hook with CalNOC.

VI. Review of goals for 2001 - goals have been met.

VII. Adjourn