Confronting the nursing shortage: An emergency department fellowship
Stacy Kirkwood, BSN, RN, CA-SANE; Debra Howard, BSN, RN; Jill Benns, MSN, RN, CENP, PCCN-K; Lisa Granado, BSN, RN, CEN
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Session F presented Tuesday, October 1, 11:30 am-12:30 pm
Purpose: Develop an educational program to combat a 40% RN turnover rate at a large inter-city hospital; while providing professional development opportunities for experienced nurses requiring emergency department specific training.
Design: The Emergency Department Fellowship was designed as a quality improvement project to ensure experienced nurses develop the strong clinical judgment necessary to provide competent care to patients within the emergency department. The fellowship is a blended learning approach leveraging self-paced online learning utilizing the ENA Emergency Nursing Orientation modules, simulated patient care scenarios, and practical on the job training.
Setting: Large teaching, safety net, level I trauma center.
Participants/Subjects: Nurses with greater than one year of experience in acute care settings who apply to expand their practice by working within the emergency department. Candidates were further narrowed through performance based interviews. Preference was given to internal applicants.
Methods: Evaluation methods included a pre/post knowledge assessment examination and interactive simulation experiences. Competency was evaluated through precepted clinical shifts in the emergency department.
Results/Outcomes: Upon completion of the first year of the project, we demonstrated a decrease in the emergency department RN vacancy rate and significantly reduced the number of travel RN's required to staff the emergency department. This was accomplished by successfully graduating 19 fellows; a 95% completion rate.
Implications: Prior to the inception of this program, the department only hired nurses with emergency department experience. As an organization, there was no bridge to professionally develop experienced nurses who wanted to expand their practice to other specialty areas; which caused an increase in nursing turnover. Implementation of the Emergency Department Fellowship allowed individualized training; which controlled costs, yielded higher program satisfaction, and aligned our organization with professional development practices outlined by Magnet standards.
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