Exploring the Structure and Content of Hospital-Based Pediatric Nurse Residency Programs.

UNLABELLED: This paper presents the results of a national survey of pediatric nurse residency programs (NRP). DESIGN AND METHODS: The Pediatric Nursing Certification Board (PNCB) database was used to identify 316 hospitals with pediatric units, including children's hospitals and community hospitals with pediatric services. The Residency Task Force of the Institute of Pediatric Nursing (IPN) developed the survey, Exploring Pediatric Nurse Residency Programs. Survey items addressed structure, content, outcomes, benefits and challenges of NRPs, including a comparison with orientation programs and use of preceptors. RESULTS: Of the 316 hospitals contacted, 65 provided usable information and 45 reported having an NRP. Most (94%) of the hospitals have an orientation program, and 70% had an NRP. The NRPs were typically internally developed (60%) and a year in length (46.5%). Most common content (>80%) included critical thinking, stress management, small group support, professional role transition, pediatric resuscitation, and evidence based practice. Evaluation of the NRPs included measures of satisfaction, turnover rates, and standardized measures, primarily the Casey-Fink Graduate Nurse Experience Survey (48.7%). Challenges include obtaining financial support from the organization, developing content relevant across units, providing time away from clinical units, and maintaining preceptors. Benefits noted included development of professional role confidence and peer support networks, increased safe nursing practices, and a decrease in nursing turnover. CONCLUSIONS AND PRACTICE IMPLICATIONS: In the ongoing development of NRPs in children's hospitals, issues such as appropriate content, optimal length, standardization across settings, impact on nurse retention, safe practice and patient outcomes all need to be addressed.

A Hospital-Based Interdisciplinary Model for Increasing Nurses' Engagement in Legislative Advocacy.

The Legislative Action Interest Group (LAIG) is a hospital-based health policy forum that engages nurses in exploring clinical implications of existing and pending health policies and regulations, while also creating a feedback loop to inform policy makers about the realities nursing practice and patient care. The LAIG is a collaborative effort between the hospital's Department of Nursing and Patient Care Services and the Office of Government Relations at an academic children's hospital. Nurses participating in the LAIG forums build a working knowledge of health policy and can articulate the practice realities for policy decision makers. Participants explore the political context of nursing and pediatric policies while learning about the state legislative process. Beyond the monthly meetings, members build policy advocacy skills and have testified at public hearings, met with state and federal legislators, and led tours for policy makers through the hospital. The LAIG model also benefits the government relations staff by providing time for them to discuss clinical implications of pending policies with nurses from practice settings in the hospital. Forum discussions enhance the ability of the hospital's lobbyists to articulate practice implications of health policy to lawmakers. This case study, describing the origin, structure, operations, and outcomes of the LAIG model, and has implications for nurses in hospitals and academic settings who are interested in engaging in policy work. Opportunities to research the sustainability, replicability, and patient-centered outcomes of LAIG forums represent future work needed to advance nursing's participation in policy.

Electronic medication reconciliation and medication errors.

OBJECTIVE: To measure the impact of electronic medication reconciliation implementation on reports of admission medication reconciliation errors (MREs). DESIGN: Quality improvement project with time-series design. SETTING: A large, urban, tertiary care children's hospital. PARTICIPANTS: All admitted patients from 2011 and 2012. INTERVENTIONS: Implementation of an electronic medication reconciliation tool for hospital admissions and regular compliance reporting to inpatient units. The tool encourages active reconciliation by displaying the pre-admission medication list and admission medication orders side-by-side. MAIN OUTCOME MEASURE: Rate of non-intercepted admission MREs identified via a voluntary reporting system. RESULTS: During the study period, there were 33 070 hospital admissions. The pre-admission medication list was consistently recorded electronically throughout the study period. In the post-intervention period, the use of the electronic medication reconciliation tool increased to 84%. Reports identified 146 admission MREs during the study period, including 95 non-intercepted errors. Pre- to post-intervention, the rate of non-intercepted errors decreased by 53% (P = 0.02). Reported errors were categorized as intercepted potential adverse drug events (ADEs) (35%), non-intercepted potential ADEs (42%), minor ADEs (22%) or moderate ADEs (1%). There were no reported MREs that resulted in major or catastrophic ADEs. CONCLUSIONS: We successfully implemented an electronic process for admission medication reconciliation, which was associated with a reduction in reports of non-intercepted admission MREs.

A nursing career lattice pilot program to promote racial/ethnic diversity in the nursing workforce.

The nursing career lattice program (NCLP) at Children's Hospital Boston has provided employees with social, educational, and financial assistance as they begin or advance their nursing careers. At the conclusion of a pilot phase, 35% of employees in the NCLP were enrolled in nursing school and 15% completed nursing school. The NCLP exemplifies how a workforce diversity initiative can lead to outcomes that support and sustain a culture rich in diversity and perpetuate excellence in nursing in one organization.

Increasing Racial and Ethnic Diversity in the Nursing Workforce: One Pediatric Hospital's Strategic Approach.

BACKGROUND: The 2021 Future of Nursing Report 2020-2030: Charting a Path to Achieve Health Equity recognizes increasing racial and ethnic diversity in nursing as an imperative to achieving health equity. PRACTICE INITIATIVES: Over a 3-year period, nursing and human resource leaders at Boston Children's Hospital, a tertiary care, 454-bed pediatric academic medical center in Massachusetts, developed, implemented, and evaluated specific strategies to increase racial and ethnic diversity in recruitment and hiring of the nursing workforce. These specific strategies focused on cultivating partnerships, building relationships with candidates, and supporting transition into practice. RESULTS: Significant increases in racial and ethnic diversity recruitment and hiring were achieved over the 3-year period. In 2019, strategies yielded a 6% overall increase in total registered nurse diversity hiring with an 18% increase in new graduate diversity hires over 2018. In total, 16.2% of registered nurse hires for 2019 were racially and ethnically diverse. Subsequent years yielded similar success in the recruitment of diverse registered nurses. CLINICAL IMPLICATIONS: With the projected growth of racial and ethnic minority populations, nursing and health care leaders must prioritize intentional strategic diversity recruitment and retention actions to address this imperative to advance health equity through the creation of a racially and ethnically diverse nursing workforce.

Helping High School Students Explore Nursing Careers in a Summer Internship Program.

Although nursing remains the most trusted profession in the United States, it is still challenging to attract high school students due to a perception that nursing may not be as intellectual, challenging, or prestigious as other careers in health care. Nursing professional development practitioners can create an opportunity to change this perception by engaging high school students through a summer internship program. The Student Career Opportunity Outreach Program embeds high school students in the hospital environment, enabling them to be a part of a clinical area and engage with nurses in a meaningful way. This article aims to explain the components of the summer internship program for high school students in a pediatric academic medical center and discuss findings from a survey exploring career choices pre- and postprogram as well as other outcome measures.

An Inpatient Child Passenger Safety program.

Background. Our institution implemented an Inpatient Child Passenger Safety (CPS) program for hospitalized children to improve knowledge and compliance with the Massachusetts CPS law, requiring children less than 8 years old or 57 inches tall to be secured in a car seat when in a motor vehicle. Methods. After the Inpatient CPS Program was piloted on 3 units in 2009, the program was expanded to all inpatient units in 2010. A computerized nursing assessment tool identifies children in need of a CPS consult for education and/or car seat. Results. With the expanded Inpatient CPS Program, 3650 children have been assessed, 598 consults initiated, and 325 families have received CPS education. Car seats were distributed to 419 children; specialty car seats were loaned to 134 families. Conclusions. With a multidisciplinary approach, we implemented an Inpatient CPS Program for hospitalized children providing CPS education and car seats to families in need.