As the demand for nurse practitioners in critical care units continues to grow, the importance of successfully integrating these providers to improve retention and outcomes increases as well.
According to an article published in the journal Critical Care Nurse, the University of Maryland Medical Center in Baltimore helped develop successful nurse practitioners in all 10 of its intensive care units through training programs and other strategies. Of the 250 nurse practitioners employed at the Magnet-designated center, 90 practice in an ICU setting.
"New nurse practitioners enter practice with variable backgrounds in education and nursing experience," said Shari Simone, DNP a pediatric critical care nurse practitioner and senior nurse practitioner clinical program manager with UMMC's women's and children's services. "UMMC developed a centralized leadership structure for advanced practice providers, including nurse practitioners, in 2008. This strategic approach has led to establishing new programs and processes that directly affect their success as clinicians."
Here are four strategies implemented at UMMC to improve nurse practitioner integration into critical care units.
1. Create orientation and training programs. At UMMC, new nurse practitioners receive resource manuals equipped with learning materials and a specialty competency-based assessment tool. Orientation is 12 to 26 weeks, depending on competency expectations and the knowledge of the new providers. Also, UMMC developed a postgraduate fellowship program to train small cohorts of critical care nurse practitioners. The program lasts for six months and included classroom sessions, rotations through various ICUs, procedural workshops and care simulations.
2. Define the new nurse practitioner's role. Conduct a needs assessment to develop a vision for the new employee's role and provide the nurse practitioner with clearly written job descriptions detailing expectations.
3. Create a management team. Assemble an advanced practice leadership team headed by a lead nurse practitioner to coordinate recruitment, interviews, selection, orientation and performance management.
4. Evaluate performance. Performance evaluations for ICU nurse practitioners should include standardized competency assessment and weekly evaluation during orientation, a focused professional practice evaluation and an annual performance evaluation designed to offer feedback from both peers and providers across multiple disciplines.
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