Talk was given about the role librarians can play in Magnet Organizations.

1. Magnet Facilities and the Role
Medical Librarians Can Play
Alison J. Montpetit, PhD, RN-BC & Roy Brown, MLIS, AHIP
September 18, 2019

2. Objectives
9.18.19NNLM Continuing Education 2
1. Importance of Translation - The Why
• Discuss the importance of translating research to
practice
• Review Nursing’s role in translation through evidence-
based practice
2. Magnet Recognition – The What
• Review the Magnet Model
• Discuss how the Magnet Recognition program
facilitates translation of research to practice
• Discuss standards/exemplars required for accreditation
• Review standards specific to evidence-based practice
3. Characteristics of a Magnet Organization – The How
• Review organizational culture and elements that include
evidence-based practice
4. Partnerships with Medical Librarians – The Who
• Discuss experience: challenges and barriers
• Discuss successes

3. VCU Health
▪ 779 Bed Urban Academic Medical Center
▪ 3 Time Designated Magnet Facility
▪ 11,000 Employees (3500+ Nurses)
▪ Active Beacon Award Units – 11
VCU Libraries:
Tompkins-McCaw Library for the Health Sciences
▪ VCU Libraries: Two Libraries
• James Branch Cabell Library: Academic Campus
• Tompkins-McCaw Library: Medical Library
▪ Liaison Program
• 7 Librarians - Research and Education Department
• Nursing, Medicine, Allied Health, Dentistry, Pharmacy &
Consumer Health

4. Importance of TranslationThe Why
9.18.19NNLM Continuing Education 4

5. Importance of Translation
Imperative: Narrow the research to practice gap
• 17 years to move evidence from the research to clinical practice
9.18.19NNLM Continuing Education 5
● National Academy Goal:
● 90% of Decisions Based on Evidence By 2020
■ Today…
■ BMJ Study: 18% of recommendations were based on
consistent, high-quality patient-oriented evidence,
while approximately half were based on expert
opinion, usual care or disease-oriented evidence.
TAKEAWAY
Magnet organizations
*may be better at translation
(See Slide 13)

6. Healthcare Today:
Moving to Clinical Decision Making Based on Evidence
• Opinions (Own
& Colleagues)
• Past
Experiences
• Precedents
Previous
Healthcare
Practice
• Science
• Research
• Evidence
Present
Healthcare
Practice
Greiner, A.C. et al Health Professionals Education: A Bridge to Quality 2003
6

7. Healthcare Today:
Government Policy & Reimbursements
Affordable Care Act
Goals
1. Expand Access to Health Insurance
2. Protect Against Arbitrary Actions of
Insurance Companies
3. Reduce Costs
Centers for Medicare & Medicaid
Services
Reimbursements Based:
1. Patient Satisfaction
2. Readmissions
3. Length of Stay/ Throughput
Private Payers / Insurance Companies
Reimbursements Based:
1. Evidence Based Procedures / Interventions

8. Healthcare Today:
Aim to Improve Care and Drive Down Costs
● Triple / Quadruple Aim - Institute for Healthcare Improvement
Per Capita
Cost of
Health
Care
Population
Health
Patient
Care
(Quality &
Satisfaction)
Per Capita
Cost of
Health
Care
Population
Health
Care Team
Well-Being
Patient
Care (Quality
& Satisfaction)

9. Facts about Nursing
9.18.19NNLM Continuing Education 9
● ~4 million Nurses in United States
○ Largest Group of Healthcare Providers
○ RN’s, Nurse Practitioners, Midwives
○ Ph.D., DNP, Master’s, BSN, ADN prepared
○ Clinical/Hospital, Ambulatory, Community
Settings
● Systems and prevention focus
● Linking all professional levels of
nursing to engage in narrowing the
research to practice gap and achieving
the quadruple aim.

10. 10
RESEARCH
EVIDENCE – BASED PRACTICE PI - QI
Knowledge Translation

11. Magnet RecognitionThe What
9.18.19NNLM Continuing Education 11

12. ANCC Magnet Recognition Program
American Nurses Association (ANA), American Nurses Credentialing Center (ANCC)
Facts about Magnet
• History – 14 Forces of Magnet (1983)
• Rigorous application and review process (4-year designation)
• 498 Recognized, International
• Pathways to Excellence
Why is Magnet Recognition Important?
9.18.19NNLM Continuing Education 12
VCU Medical Center in
process of 4th re-designation

13. 14 Forces of Magnetism
13
1. Quality of Nursing 8. Consultation and Resources
2. Organizational Structures 9 . Autonomy
3. Management Style
10. Community & Health Care
Organization
4. Personnel Policies & Programs 11. Nurses as Teachers
5. Professional Models of Care 12. Image of Nursing
6. Quality of Care 13. Interdisciplinary Relationships
7. Quality Improvement 14. Professional Development
McClure, M. L., Poulin, M. A., Sovie, M. D., & Wandelt, M. A. (1983). Magnet hospitals: attraction and
retention of professional nurses. American Academy of Nursing. Task Force on Nursing Practice in
Hospitals.

14. Impact of Magnet Recognition
● Nurse Recruitment/Retention
● *Organizational Quality & Safety
○ Higher support for evidence-based
practice implementation
■ Melnyk, Gallagher-Ford, Fineout-Overholt, &
Kaplan, 2012
● Better Patient Outcomes
● Lower Costs
○ Length of Stay
○ RN Turnover
14
https://www.nursingworld.org/organizational-programs/magnet/library-of-magnet-journal-articles/

15. ANCC Magnet Model
9.18.19NNLM Continuing Education 15
https://www.nursingworld.org/organizational-programs/magnet/magnet-model/
Organizational
Overview

16. 16
• Organizational Overview (OO): Describes various aspect of the organization
• Empirical Outcomes (EO): The measurement of nursing's contribution to patient care,
nursing work environment, and more
• Transformational Leadership (TL): Empowered leader who ensures nursing at all
levels have a voice that is heard, their input valued and practice supported
• Structural Empowerment (SE): Clinical Nurses are involved in shared-governance,
decision-making and establishing standards of practice
• Exemplary Professional Practice (EP): The existence of a robust Professional
Practice Model and how it defines care
• New Knowledge, Innovations & Improvements (NK): Nursing Inquiry and
Innovation
Magnet Standards of Excellence (SOE)
9.18.19NNLM Continuing Education
• Organizational Overview (OO): Describes various aspect of the organization
• Empirical Outcomes (EO): The measurement of nursing's contribution to patient care,
nursing work environment, and more
• Transformational Leadership (TL): Empowered leader who ensures nursing at all
levels have a voice that is heard, their input valued and practice supported
• Structural Empowerment (SE): Clinical Nurses are involved in shared-governance,
decision-making and establishing standards of practice
• Exemplary Professional Practice (EP): The existence of a robust Professional
Practice Model and how it defines care
• New Knowledge, Innovations & Improvements (NK): Nursing Inquiry and
Innovation

17. 179.19.19NNLM Continuing Education
What is an SOE or Magnet Exemplar?
In a Magnet application, organizations describe nursing
practice through approximately 90 standards! Of those,
69 are Standards of Excellence (SOEs) which request
specific exemplars based on the standard definition.
NOTE: Each standard is unique!
Let’s discuss 2 example SOEs relevant to EBP…
• New Knowledge, Innovations & Improvements (NK)

18. 9.18.19NNLM Continuing Education 18
11
22
21
15
Large %
focus on
Research,
EBP or PI
Organizational
Overview10
TAKEAWAY
Research is as
important as
EBP/PI
To apply,
organizations must
have a minimum of:
2 completed
1 ongoing
*nurse-driven
research studies
*must be employed by the
hospital

19. Characteristics of a
Magnet Organization
The How
9.18.19NNLM Continuing Education 19

20. Organizational Culture of EBP
Visible in Organizational Structures & Systems:
• Professional Practice Model
• Shared Governance Structure
• Transition to Practice/Orientation (Nurse Residency Programs)
• Advancement (Clinical Ladder)
• BSN and Certification Rates
• Research, EBP, Performance Improvement initiatives
• Job Descriptions, Performance Appraisals
• Recognition, Magnet Accreditation
• Continuing Education, Tuition Assistance
• Library Resources / Support
• Language/Communication
209.18.19CVANPD Continuing Education
What
does the
evidence
say?
TAKEAWAY
Medical
Librarians are
highly valued in
Magnet
organizations

21. Various EBP Models in Nursing
• ARCC Advancing Research and Clinical Practice
through Close Collaboration*
• Ohio State Helene Fuld Health Trust National Institute for EBP in
Nursing and Healthcare
• Offers EBP Certificate (EBP-C)
• Johns Hopkins Nursing EBP Model
• Iowa Model for EBP to Promote Quality Care
• ACE Star Model of Knowledge Transformation
• PARiHS or i-PARiHS integrated Framework Promoting
Action of Research Implementation in Health Services
• Stetler’s; Rosswurm and Larrabee; 5 A’s
• I3 (Inquiry, Improvements & Innovations) Model for
Advancing Quality Patient Centered Care
219.19.19NNLM Continuing Education
PROCESS vs. SYSTEM*
TAKEAWAY
By understanding the model used
in an organization – you can
better plan ways to connect OR
you can help the organization
identify an EBP Model

22. ARCC© Model – System Model
22DateModify with Insert > Header & Footer
TAKEAWAY
By understanding this systems
model – you can better plan ways
to connect OR you can support
organizational assessments to
evaluate readiness for EBP

23. Nursing Inquiry Process @ VCU Health
• Johns Hopkins EBP Model
• VCU Health Inquiry Process Diagram
• Serves as Supplement to the Model
• Created by Medical Librarian, Roy Brown in consultation with
nurses from VCU School of Nursing and VCU Health
• Breaks down difference between EBP, Research, and PI/QI
• Further enhanced with an online portfolio with just-in-time
instruction.
239.18.19NNLM Continuing Education

25. DateFooter 25
RESEARCH
EBP
PI/QI
NURSE RESIDENCY PROGRAM
EBP INTERNS & SCHOLARS PROGRAM

26. 9.10.19
Partnerships with Medical
Librarians
NNLM Continuing Education 26
The Who

27. 27
Knowledge Translation
KEY: Comprehensive QUALITY Evidence
and Process
Medical
Librarian

28. The Librarian and Magnet Organizations:
General Roles
1. Assist with Finding Evidence / Literature Searches
• Refine the Question & Identify Internal Data Sources to Support
2. Partner with Nursing Education & Prof. Development Depart.
• Assist with designing classes addressing the various aspects of EBP
3. Assist with Dissemination of Nursing Projects
4. Serve on Hospital Councils or Committees
• Nursing EBP Council
• Magnet Champions Committee
• Practice Councils
• Nursing Leadership Forums

29. The Librarian and Magnet Organizations:
General Roles
5. Serve as a Connecting Agent – People and Resources
Librarian
Sources of
Data
Practice
Councils
Nursing
Units
Evidence/
Literature
Hospital
Experts

30. Getting Started in Your Own Organization
● Nursing Administration & Leadership
○ Chief Nursing Officer
○ Department/Division Nursing Directors
● Magnet Coordinator or Magnet Program Director
● Nurse Residency Programs
○ Meeting the new graduate nurse but also working with the
resident facilitators
● Education and Professional Development
Department
● Nurse Educators
Partnerships and Opportunities

31. Wrapping Up
● Magnet Organizations - Evidence & Outcomes Focused
● Identify Partners in Your Organization
○ Chief Nursing Officer
○ Nursing Administrators
○ EPD/ Nurse Educators
● Librarians Show Value
○ Showing Initiative and Being Present
○ Supporting EBP/Research/PI Programs in Org.
■ Return on Investment ($)
■ Link to Quality/Safety data/outcomes

32. Thank you…
…open for questions