1. SERVICE AREA (Edit this in the Master Slide Area) UEXCEL Credentialing Process Overview SUBTITLE

2. SERVICE AREA (Edit this in the Master Slide Area)

3. Why UEXCEL Matters To Me 1.Recognizes my nursing expertise and individual talents 2.Increases my responsibility and accountability for clinical practice 3.Serves as criteria for my performance appraisal and peer review 4.Based on American Nurses Association® National Standards of Practice 5.Opportunities for my professional growth and advancement 6.Enables my participation in hospital wide activities 7.Promotes my leadership opportunities while delivering direct patient care 8.Serves as a model for my succession planning and mentoring 9.Mark of my personal achievement 10.UCH values my advancement in UEXCEL!

4. SERVICE AREA (Edit this in the Master Slide Area) Objectives Define UEXCEL Professional Practice Program Discuss steps required for successful portfolio submission Describe portfolio organization, including key elements of portfolios and review procedures

5. SERVICE AREA (Edit this in the Master Slide Area) Background Initiated in 1990 after 2 years of planning Goal: To establish a professional practice program for all registered clinical nurses providing direct patient care Credentials nurses to practice Provides program standards of practice to unify nurses across the hospital services Standards based on ANA Standards for Clinical Nurse Practice Serves as criteria for performance appraisals Provides an opportunity for advancement and promotion, while remaining a clinical nurse Evidence-based practice and research are the foundation for professional nursing practice at UCHealth

6. SERVICE AREA (Edit this in the Master Slide Area) UEXCEL Professional Practice Program Framework: Benner’s Novice to Expert (1984), based on Dreyfus theory of skill acquisition Levels: Level I – Advanced Beginner Level II – Competent Level III – Advanced, Proficient Level IV – Expert Human Resources: Each level represents a distinct and separate job description, salary range, and new classification Categories of Standards: Exemplary Professional Practice Transformational Leadership Structural Empowerment New Knowledge and Innovation

7. SERVICE AREA (Edit this in the Master Slide Area) UEXCEL Board The UEXCEL Board is the governing body for the program Chair: Clinical Nurse Co-chair: Nursing Director Liaison Composition of Board: Clinical nurses representing clinical areas, and other members by related entities: Human Resources, Clinical Education, Nurse Management, Nursing Administration Structure: Meetings held monthly; clinical nurses commit to 3-year term of service

8. SERVICE AREA (Edit this in the Master Slide Area) UEXCEL Board Roles Reviews and approves credentials of clinical registered nurses for the four levels of nursing practice Supports the philosophy, vision, and goals of professional nursing by maintain oversight of nursing practice standards across hospital services Provides path for career promotion through mentoring, development, and education, guidance to nurses interested in advancing, and an advisor course for mentors Provides professional structure for evaluating registered nurse performance within the Human Resources Performance Management program Maintains and updates bylaws defining the UEXCEL structure and program functions Sponsors longitudinal evaluation of clinical nurse satisfaction within the UEXCEL Practice Program Supports special nursing groups within the Practice Program: example is the Level IV Nurse Council

9. SERVICE AREA (Edit this in the Master Slide Area) Clinical Nurse Practice Roles Level I Entry level Advanced Beginner: graduated from an accredited baccalaureate or Masters entry into practice program. All newly licensed registered nurses participate in the UHC/AANC Nurse Residency Program, hired into Inpatient, Peri- Operative and Emergency Services. Level II Experienced clinician who is Competent to care for complex patients. Works collaboratively on healthcare team, incorporates research and life- long learning into practice, and participates in quality initiatives. Level III Advanced, Proficient nurse clinician, recognized as leader in clinical area. Takes active role to improve patient outcomes, education and management. Promotes safety and professional development, participates in professional activities, and is certified in specialty. Level IV Demonstrates Expert clinical skills. Regarded as clinical authority and resource within the unit/service and hospital. Has significant degree of responsibility and leadership, acts as a mentor and resource, is active in professional organization, and is certified in specialty.

10. SERVICE AREA (Edit this in the Master Slide Area) What Does It Mean To Advance? Demonstrates personal achievement as a professional nurse and raises the bar for practice Provides professional growth opportunities; EBP and research projects add value to service and hospital Provides fiscal rewards: 4% increase to base pay for Level III and 7% for Level IV Certified Level III nurses receive three education days Certified Level IV nurses receive four education days Strengthens professional practice through peer review Peers contribute to performance appraisals Peer review of portfolios with voting on approval or denial of advancement is core of UEXCEL Board Valued by Manager/Director/Hospital Supported to reach goal

11. SERVICE AREA (Edit this in the Master Slide Area) Level III and IV Advancement Requirements Role Model status on current performance appraisal Currently enrolled in BSN (Level III), or holds BSN (Level IV) Specialty Certification obtained within one year (Level III), or holds Certification (Level IV) Selects Certified Advisor who has advanced to the Level the nurse applicant aspires to reach Follows steps outlined in Credentialing Procedures Completes online learning center courses on advancement process Portfolio submission

12. SERVICE AREA (Edit this in the Master Slide Area) Timeline Work should begin coinciding with the start of the fiscal year (July 1) Review Credentialing Procedures and explore project options with Manager or Educator Select Certified Advisor early on Submit Intent to Credential by deadline Achieve Role Model status on annual performance appraisal for fiscal year credentialing Submit portfolio, with supporting documentation, by deadline Review detailed timeline on UEXCEL website with Advisor

13. SERVICE AREA (Edit this in the Master Slide Area) Tips for Success Review UEXCEL Standards Read standards for your current level Know what you need to be working on to achieve Role Model status Continue to check in with Advisor frequently on progress Allow at least 9-12 months to prepare Prepare for your evaluation You must be Role Model status on your current level performance appraisal in order to be eligible for advancement Plan ahead Work consistently on your projects Include activities that have taken place during the fiscal year Maintain documentation of your work and consider updating your website throughout the project No last-minute rushes; review timeline with your Manager and Certified Advisor

14. SERVICE AREA (Edit this in the Master Slide Area) Tips for Success (continued) Follow steps outlined in Credentialing Procedures handout Learn about portfolio expectations Register for ULearn courses titled: UEXCEL Overview, UEXCEL E-Learning Part I – Intro, UEXCEL E-Learning Part II – Credentialing Mandatory completion of these courses is required. Submit ULearn transcript with Intent to Credential Form. Be sure your advisor reviews your final portfolio well before submission deadline Submit independent and completed work Documentation must reflect completed work, not future plans If work is part of a group project, your distinct contribution should be presented using highlights, notes, or details in introductory narrative Do not submit a portfolio with sections that are exactly the same as a colleague

15. SERVICE AREA (Edit this in the Master Slide Area) Choosing A Certified Advisor A Certified Advisor is someone who has taken the UEXCEL Overview course May be a Board Member who has credentialed to the Level you aspire to, who is certified as an advisor May be a nurse who has credentialed to the Level you aspire to, who is certified as an advisor May be an Educator/Associate Nurse Manager/Nurse Manager who has credentialed to the Level you aspire to, who is certified as an advisor Obtain advisor commitment signature on the Intent to Credential Form Make sure your advisor is listed on the Certified Advisor List!

16. SERVICE AREA (Edit this in the Master Slide Area) Portfolio Organization All portfolios must be presented in digital format. You are highly encouraged to take the UEXCEL Digital Portfolio Online Training ULearn. Categories of Standards: Exemplary Professional Practice Transformational Leadership Structural Empowerment New Knowledge and Innovation Type an introduction to each section Include a timeline for all sections, except Exemplary Professional Practice Follow directions in credentialing packet

17. SERVICE AREA (Edit this in the Master Slide Area) Portfolio Section I – Exemplary Professional Practice Two Letters of Recommendation RN Manager or RN Director RN Peer (not Advisor) Performance Appraisal Copy of most recent performance appraisal Role Model status Clinical Narrative Highly encouraged to take the UEXCEL Resume & Clinical Narrative ULearn Philosophy and values; how you practice these values Provide current clinical examples showing how practice has advanced/changed to reflect Level III or IV Professional Resume Documentation of Education Copy of BSN or RN to MSN diploma, or official transcript with school seal showing active enrollment for Level III Copy of Certification for Level IV

18. SERVICE AREA (Edit this in the Master Slide Area) Portfolio Section II – Transformational Leadership Unit or Institutional Project Level II to III should focus on a unit project and Level III to IV should focus on an interdepartmental, interprofessional, or UCHealth System project Value-added work that goes beyond role expectations Policy, Guidelines, and Patient Teaching Materials Developing or revising professional documents contributing to improving care, applying evidence-based practice, includes literature review, abstracts, or citations Follows appropriate committee guidelines and algorithms found on intranet site (The Source); Ambulatory Services nurses refer to the AS guidelines process and appropriate templates Patient education documents need to be submitted to the Patient/Family Education Review Subcommittee

19. SERVICE AREA (Edit this in the Master Slide Area) Portfolio Section II – Transformational Leadership Level III Examples ICU Visitation Guidelines Non-Urgent Pages to Residents Bariatric Center of Excellence Preparation/Bariatric Patient & Staff Education Binder Development for UCH Endoscopy Lab Cases Start Time Process Improvement Lovenox & Epidural Use Policy & Practice Change Level IV Examples ANCC Accreditation for CRRT Program Hypothermia Management Post Arrest in the UCH Patient Observation Charge Capture Initiative/Lead Charge RN “Nothing Left Behind” /AOP OR/Sponge Count Originated “Magnet Nurse of the Year” at UCH/Program Development & Implementation

20. SERVICE AREA (Edit this in the Master Slide Area) Portfolio Section III – Structural Empowerment Showcases engagement in improving the profession Teaching an educational program on unit or acting as instructor in skills verification programs Precepting others, developing staff education materials, patient education teaching, or presenting at a course or conference Include certificate and evaluation form samples Professional organization activities, optional CE Record, or Community Service Creating content and conducting an in-service, skills lab, poster, or teaching a CNE class, or leading a Clinical Review Session or Journal Club

21. SERVICE AREA (Edit this in the Master Slide Area) Portfolio Section IV – New Knowledge and Innovation Showcases work on quality improvement or research that has made a difference in delivery of care, requires demonstration of outcomes (i.e. data) Studies, collects, and analyzes data on unit/hospital quality issues, FOCUS-PDCA, business plan, etc. What did you do to actively improve outcomes or make a change? Includes audit forms, graphs, and literature review (see guidelines for specific criteria) Data and work must go beyond what is provided by committee/councils or Clinical Excellence and Patient Safety department Includes analysis: What will continue to be done? How to sustain the gain? Project cannot end with submitting portfolio, unless it was in reality a one-time event. Usually, there is some plan future improvement!

22. SERVICE AREA (Edit this in the Master Slide Area) Board Review Procedures Portfolios submitted to Board Secretary Secretary enters Portfolios into database Members review Portfolios in teams (peer review) More experienced members paired with new members Reviews conducted of each portfolio within team to assure criteria met If gap is detected with completeness, additional reviews conducted Each team presents pre-reviewed portfolios to full UEXCEL Board for final review; vote on acceptance, pending re-review or denial Mandatory for Level IV applicant to present portfolio to the board

23. SERVICE AREA (Edit this in the Master Slide Area) View Successful Digital Portfolios Here are examples of Level III portfolios: http://dcharney.Weebly.com/ password: dcrn3 http://laurasatorielevel3.Weebly.com/ password: acemoves http://wendymossuchlevel3.Weebly.com/ http://barbarajonesleveliii.Weebly.com/ http://katiesixta-level3.Weebly.com/ password: level_3 Here are examples of Level IV portfolios: http://lindastaubli.Weebly.com/ password: denver01 http://theresaheyborne.Weebly.com/ password: uch4 http://davidmacneill.Weebly.com/ Remember, these are just for review. E-mail UCH-UEXCELDigitalP@uchealth.org if you need more help or have questions.UCH-UEXCELDigitalP@uchealth.org

24. SERVICE AREA (Edit this in the Master Slide Area) 2015 UEXCEL Level III and IV Credentialed Nurses

25. SERVICE AREA (Edit this in the Master Slide Area) References Cummings, G., MacGregor, T., Davey, M., Lee, H., Wong, C., Lo, E., Muise, M., Stafford, E. (2010). Leadership styles and outcome patterns for the nursing workforce and work environment: A systemic review. International Journal of Nursing Studies, 47(3), 363-385. Bogossian, F.E., and Kellett, S. E.M., (2010) Barriers to electronic portfolio access in the clinical setting. Nurse Education Today, 30, 768-772. Brooks B, Olsen S, Rieger-Kligys P, Mooney, L. (1995). Peer review: An approach to performance evaluation in a professional practice model. Critical Care Nursing Quarterly, 18(3), 36-47 Driessen, E.W., Muijtjens, A.M.M., Tartwijk, J.V., & Van Der Bleuten, C.P.M., (2007) Web- or paper-based portfolios: is there a difference? Medical Education, Vol 41, 1067-1073. Johns, C. (2004). Becoming a reflective practitioner. Oxford, England: Blackwell Publishing. Kramer, M., Maguire, P., Brewer, B. (2011). Clinical nurses in Magnet hospitals confirm productive, healthy unit work environments. Journal of Nursing Management, 19(1), 1-5. Lammintakanen, J., Sarnto, K., Kivinen, T., & Kinnunen, J., (2002). The digital portfolio: a tool for human resource management in health care? Journal of Nursing Management, Vol 10, 321-328. Luzinski, C. (2011). The Magnet model: An infrastructure for excellence. Journal of Nursing Administration; 41(11), 441-442. Lewis, K.O., and Baker, R.C., (2007). The Development of an Electronic Educational Portfolio: An Outline for Medical Education Professionals. Teaching and Learning in Medicine, 19(2), 139-147. McKenzie, J.F., Cleary, M.J., McKenzie, B.L. & Stephen, C.E., (2002). E-Portfolios: Their Creation and Use by Pre-service Health Educator. The International Electronic Journal of Health Education, Vol 4, 79-83. Murphy, M., Hinch, B., Llewellyn, J., Dillon, P.J., & Carlson, E. (2011). Promoting professional nursing practice: Linking a professional practice model to performance expectations. Nurs Clin N Am., 46: 67-79. Pierson MA, Liggett C, Moore KS. (2010). Twenty years of experience with a clinical ladder: A tool for professional growth, evidence-based practice, recruitment and retention. J Contin Edu Nurs, 41(1): 33-40. Pincombe, J., McKellar, L., Weise, M., Grinter, E., & Beresford, G., (2010). ePortfolio in Midwifery Practice: “The Way of the Future”. Women and Birth, 23, 94-102. Richards, J.A., (2001). Nursing in a Digital Age. Dermatology Nursing, Vol. 13, No. 5, 365-370. Watts M.D., (2010). Certification and clinical ladder as the impetus for professional development. Critical Care Nurse Q, 33(1):52-59. Winslow, S.,A., Fickley, S., Knight, D., Richards, K., Rosson, J., Rumbley, N., (2011). Journal for Nurses in Staff Development, 27(1): 13-17.