Nursing Excellence

The Online Newsletter for Children's Nurses
e-Edition, Issue 11

Nursing Governance Structure

By Jo A. Lyons, MOB, BS, RN-BC

The organizational structure for the oversight of nursing governance is a collaborative effort made possible through a participatory governance environment. This environment allows nurses to make decisions about matters that involve nursing quality and practice.

Executive Nursing Council

Nursing Strategic Plan
Plan for the Provision of Care
Nursing Governance Oversight
Quality (NDNQI, PI)
Legislative Advocacy
Recognition

Nursing Research Council	Nurse Practitioner Council	Nursing Peer Review Committee	PCD Leadership
-Research -Publications -Evidence-Based Practice	-Standardized -Procedures -Scope of Practice	-Case Review -Quality Improvement	-Patient Care Operations

Practice Council	Nursing Informatics Council	Professional Development Council
-Policy and procedure -Evidence-based practice -Scope of Practice	-Consult on Clinical Applications -Test Validation of Clinical Applications -Support, Standardize, Evidence-Base, Safe, Technology Solutions	-Orientation -Continuing Education -Staff Development

Summary of Accomplishments by Councils/Committee

Nursing Research Council

The Council began development of a webpage, evidence-based practice (EBP) toolkit, to be housed on iCare, Children’s clinical nursing portal.
Attendance has increased by 42 percent at the quarterly Journal Club meetings; the focus is the review of a research article at each meeting.

Nurse Practitioner (NP) Council

Scope of Practice/ Delineation Form has been modified and continues to be updated to include more consistent proctoring requirements for all NPs.
Standardized Procedure (SP) processes for approval have been modified and improved.
NPs participated in the development and training of computerized provider order entry (CPOE).
NP providers continue at over 40 this year, serving in a variety of clinics and services.
International support was provided through job shadowing for visiting Thai nurses.
NPs promoted community education through National Association of Pediatric Nurse Advanced Practitioners (NAPNAP). A number of NPs serve as board members on the local affiliate of the national organization. NPs also served on community outreach organizations such as the Obesity Task Force and School Nurse Training.

Practice Council (PC)

Established link between unit councils and PC to aid in succession planning
Facilitated the communication of new practice issues throughout the division of nursing
Supported Nursing Informatics Council by coordinating practice decisions to standardize electronic clinical documentation
Changed standard in frequency of vital signs and patient assessment from every six hours to every four hours

Nursing Informatics Council (NIC)

Built and implemented a clinical documentation system for respiratory care practice and nursing care practice
Developed nursing orders related to CPOE

Professional Development Council (PDC)

Advanced Clinical Systems (ACS) implementation through staff education
Revised and enhanced extended practice competency validation and document process
Education completed on product conversions as follows: Masimo pulse oximeter, Bair Hugger upgrade, Zoll Biphasic defibrillator Phase I; ambulatory, Zoll Biphasic defibrillator Phase II; acute care, Covidien Kangaroo Feeding Pump 924.
Provided and implemented education on the Pediatric Early Warning System Score (PEWSS). Through PEWSS, whole system measure Code Blues were reduced by 62.5 percent, which translates into 14 lives saved.
In the first quarter of 2012, Children’s achieved two out of three months without Code Blues being called.

Nursing Peer Review Committee (NPRC)

The Nursing Peer Review Committee monitored the quality of nursing care offered to patients and provided a venue for identifying and recommending opportunities for improvement.