SANDRA K. JANZEN, MS, RN, CNAA
ASSOCIATE CHIEF OF STAFF/NURSING
JAMES A. HALEY VETERANS' HOSPITAL
TAMPA, FL 33612
COMMITTEE ON VETERANS' AFFAIRS
UNITED STATES SENATE
June 14, 2001
Mr. Chairman and members of the Committee, I am honored to be here to present the Tampa VA Hospital and Clinics' journey for nursing excellence and to describe our environmental characteristics that support professional nursing. In March, we became the first VA organization to achieve the prestigious Magnet designation - recognition by the American Nurses Credentialing Center ( ANCC) for excellence in nursing services. We were the 30th of only 34 facilities nationally to achieve this designation since the program's inception in 1994.
Magnet recognition is an organizational certification process based on quality indicators and standards of nursing practice defined by the American Nurses Association for nurse administrators and nursing services. The primary objective of Magnet recognition relating to this discussion is "to promote quality in a milieu that supports professional nursing practice."
Achieving Magnet recognition requires strong organizational support for professional nursing practice, a positive work environment recognizing the nursing contribution, a culture of excellence, and nursing input into organizational decision-making. A Magnet culture must be real - the site visit depends almost entirely upon the front line nursing staff to validate the written application and working environment.
The Tampa VA set its goal for Magnet recognition to acknowledge the nursing contribution to the organization's quality journey. The Magnet criteria would serve as a guide for self-evaluation. The nursing shortage was beginning and I knew Magnet organizations had less difficulty with recruitment and retention. Lastly, I wanted public validation of our already strong reputation and for VA nursing.
Organizational support for professional nursing practice. Hospital leaders provide strong organizational support for nursing at the Tampa facility with an adequate staff mix and strong educational support for new and existing staff. Nurses are highly integrated in all clinical programs, are leaders within the organization, and are allowed clinical autonomy. The nurse executive has the ability to pilot programs within existing resources to enhance practice. For example, evening and night nursing supervisory positions were eliminated to augment clinical staffing thus empowering nurses to make clinical and administrative decisions.
Positive work environment that recognizes the nursing contribution. Nurses are recognized individually and for team contributions. A Gold Star Program honors employees for exceptional customer service. Thank you letters for outstanding patient care performance are sent from hospital leadership. Nurses receive peer recognition in semi-annual nursing ceremonies. Nurses are respected for their knowledge evidenced by their leadership and membership in clinical teams. As a result of the self-assessment process, enhanced educational opportunities for nurse managers are now provided and a work plan to address nurse satisfaction issues is in place. There is a real commitment to become an Employer of Choice.
Culture of excellence. Magnet criteria address the quality of clinical care. Our organizational expectation for patient care is clinical excellence and veteran-focused. And, our record of measuring nursing quality prepared us for participation in a national quality indicator project to improve nursing practice and satisfaction. Magnet also emphasizes a positive work environment for nurses. Our VA Patient Safety Center is systematically using ergonomic analysis to identify ways to ease the patient care burdens on an aging nursing staff.
Organizational decision-making. The nurse executive is involved in decisions regarding allocation of facility resources. The Facility Quality Council assures nurses are on all Quality Improvement Teams. Nursing staff decisions regarding patient care are respected - nurse managers make critical care bypass decisions based on patient needs and staff availability. One outcome of nursing involvement in decision-making is the installation of ceiling mounted patient lifts in patient care rooms for the new Spinal Cord Injury Center - a direct result of nursing research and input.
Achieving Magnet recognition is not a quick fix for the recruitment and retention problems facing the VA. But the criteria should be used to measure progress toward creation of a Magnet culture that supports professional nursing practice and respects the voice of nursing in organizational decision-making. Really hearing and understanding nurses' concerns are critical if we are to improve the environment for nursing practice and maintain a high quality VA nursing workforce.
The creation of a Magnet culture at Tampa is evident, not only for nursing staff but also all members of the organization. Magnet designation raises the bar for employees by establishing higher standards for performance. As a result, Tampa nurses recognize the increased expectation for providing exceptional care and customer service. They face many workload challenges due to an unrelenting and growing demand, yet remain optimistic. Nurses are proud to work at the Tampa VA.
This concludes my statement. I will be happy to respond to the Committee's questions.