No Disclosures There have been NO influential relationships - PDF document

APNA 29th Annual Conference Session 3036: October 30, 2015 Sally Ann Corbo, Ed.S., APN ‐ BC, NEA ‐ BC sacorbo@epicare.com Epicare Associates, Inc. October 30, 2015 www.epicare.com No Disclosures • There have been NO influential relationships disclosed in the planning of this session. • Session planning has NOT been influenced by commercial support. • There is no commercial support for this activity. • No off ‐ label use of FDA approved products will be discussed in this session. Purpose and Objectives If you are responsible to educating staff, chart the course of regulatory standards for psychiatric nursing staff. Learn the federal, national, state and professional requirements along with effective methods to teach and document training. Measuring outcomes of education will be discussed as we turn the jungle ride into smooth sailing. At the completion of this program the learner will be able to: 1. State the mandatory training requirements for psychiatric mental health nurses and advanced practice nurses. 2. Differentiate between Competency Assessment and Performance Appraisal/Evaluation. 3. Employ effective documentation techniques to meet the required standards. 4. Implement clinical outcome measurement of education and training. Corbo 1

APNA 29th Annual Conference Session 3036: October 30, 2015 Achieving Success with Regulatory Training  Ideally, one person within the organization interprets the standards and disseminates them; during a survey this is the person who should speak to the rationales.  A centralized approach works best to ensure that staff within the same job title/responsibilities are given the same training and evaluation method. This will also enable an aggregate measurement of outcomes. Training programs need to improve clinical practice and keep staff up to date on changes.  There needs to be a tracking system/learning management system (LMS) to ensure 100% compliance. The responsibility for tracking can be de ‐ centralized. Interpreting Standards and Regulations  Become familiar with the standards and its intent.  Internal versus External standards  Networking can be very helpful  Is the purpose of the standard to provide information or to measure competency?  The difficulty is that many standards leave it up to the organization to decide the frequency and method.  This may be determined by State Laws.  In many cases there is no “right” answer; however, consistency and adherence to the organization’s own standard is key. Regulations for Training and Education Employer Practitioner  License  Center for Medicare/Medicaid • CE for Re ‐ licensure • Restraints/Seclusion  Federal o State specific: refer to download  APRN • CDC • CE for Re ‐ licensure • FDA • Psychopharmacology CE • HIPAA  Certification • FEMA • Application & Renewal • FBI • ANCC  The Joint Commission o 150 hours every 5 years/75 hrs must be CE • CAMBH – Behavioral Health o APN’s must have 25 contact hours • CAMH ‐ Hospital for pharmacology  State Department of Health Source: http://www.nursecredentialing.org/RenewalRequirements.aspx Corbo 2

APNA 29th Annual Conference Session 3036: October 30, 2015 Types of Programs Program Curriculum Bloom’s Taxonomy Evaluation Methods  Paper and Pencil Tests  Cognitive Online tests •  Psychomotor  Demonstration/Re ‐ demonstration  Affective Skills Labs • Clinical Observation •  Interpersonal Interactions Source: Bloom, B. S. (1956). Taxonomy of Educational  Role Play Objectives, Handbook I: The Cognitive Domain. New York: David McKay Co Inc.  Group Facilitation Competency Assessment versus Performance Appraisal Competency Assessment Performance Appraisal  New staff have their competence  Assesses how well a staff member assessed as part of the employment actually performs their job process, prior to being given a patient duties/responsibilities according to their care assignment. job description.  The competency of each staff member is  Annual competency assessment can be assessed through an ongoing process. added to performance appraisal.  The competency assessment process and performance review system are utilized to assure competency of all staff. Corbo 3

APNA 29th Annual Conference Session 3036: October 30, 2015 Designing an Annual Competency Program Determinants Competencies  Standard or Universal  New/Updated regulations  Organizational Strategic Plan Applies to everyone •  Core – Divisional  Divisional/Departmental Goals Within the same role/job description •  PI Data/Findings  Critical  Sentinel Events Decided annually •  Staff Incidents/Injuries Based on changes, high risk, problem • prone PI data/findings • Training Process Program Planning Assessment/Gap Analysis  Who has to be trained  Federal, State, TJC Requirements  Job Description  What do they need to learn  PI Data  When are they available  Strategic Plan  How should they be taught  Assessing Learning Needs  Why do they have to learn this • New and Transferred Employees o Educational Background o Previous experience o Learner’s Perceived Needs o Skills Checklists/Documentation Training Implementation Implementation  Type of training required  Available resources • Instructional o Competency Day o Topic of the Month • Technology o E ‐ Learning • Financial o Grants  Total # of staff to be trained  Amount of time for training Corbo 4

APNA 29th Annual Conference Session 3036: October 30, 2015 Training Evaluation Evaluation  Method of Evaluation Correlation to objectives •  Determining Outcomes Terminal Objective •  Measuring Outcomes Use available data • o HCAHPS – Hospital Consumer Assessment of Healthcare Providers and Systems o HBIPS – Hospital Based Inpatient Psychiatric Services o Patient Satisfaction o Code statistics o Medical o Behavioral o Restraints/Seclusion Documentation Tests for knowledge  Standardized Versus Facility specific  Passing Grade – Must Be Consistent  Failures • Number of retakes; time interval; can they continue to work e.g. Constant Observation; Medication Administration Skills Demonstration  Skills/Competency Checklist Affective Behaviors  Observation/Feedback Form  In Class Role Play  Unit Based Interactions e.g. Groups Measuring Outcomes The current focus is away from measuring objectives to measuring outcomes.  Rather than ‘state’, ‘identify’, ‘apply’…  … ‘the participant of the review course will successfully pass the ANCC certification exam.’ Corbo 5

APNA 29th Annual Conference Session 3036: October 30, 2015 Kirkpatrick’s Four Levels of Evaluation What level is measured by:  Written Tests  Demonstrations  Observations  Focus Groups  360 Feedback  Organizational Metrics Analyzing Results Successes Opportunities  Which results most dramatically  Which results: suggest:  Provide evidence that some learning objectives were not met? Program’s potential strengths? •  Suggest any negative, unexpected Successfully achieved the learning • objectives? outcomes?  Suggest a need for additional  Did the program produce any follow ‐ up i.e. on the job coaching, positive, but unexpected mentoring, job aids? outcomes? Challenging Regulations  Restraints and Seclusion • Verbal De ‐ escalation  Workplace Violence • Active Shooter Training  CPR Training  Contract Employees  Forensic Staff  Transferred Employees Corbo 6

APNA 29th Annual Conference Session 3036: October 30, 2015 Questions  Questions? Corbo 7