Making NPD Indispensable

Sue Johnson, PhD, RN, NE-BC

When I first became a Nursing Professional Development educator many years ago, I was delighted to hone my teaching skills, develop, and present interesting programs assigned by organization leaders. After a few years, I was promoted to manager and my focus changed. Suddenly, I had to gain budgeting and personnel management skills. Of course, there were courses available that taught me the concepts. Whenever I could, I still liked to keep my hand in class delivery because I loved the positive feedback.

As I gained expertise in my new role, I found significant challenges that I didn't see as a staff educator. It was no longer enough to create positive learning activities. Now, I had to become a leader and change agent whether I wanted to or not (ANPD, 2016). It became obvious that I had to be "at the table" to understand and give input on organizational decisions that affected my department. Since I was well known in the organization, I pushed myself into planning sessions with the rationale that we would provide better service if we were involved in the planning process.

Naturally, there soon were too many committees and task forces for me to handle alone. Luckily, I had a core staff of ten educators and each was fascinated by involvement with different groups and challenges. Some of you are now saying, "Sure, it's easy with multiple educators". Actually, it's easier to get a handle on smaller numbers and you can start small and make a case for additional educators as projects evolve and the need for your services increases. The trick is to align your skills with organization initiatives and interprofessional teams to achieve results (Ives Erickson, Jones, & Ditomassi, 2013). This is an opportunity to make NPD indispensable and it will pay dividends when finances are tight and staffing cuts are being considered.

Visibility is vital! It's easy to cut in areas that aren't seen often. Out of sight, out of mind is true in health care as it is elsewhere. NPD must be visible to survive and thrive. Another point to consider is the worth of NPD services to the organization. I am not a math wizard, but I learned that a couple of simple (and they are) calculations for major programs can prove the department's worth to administrators and especially the finance folks. We need them as allies and they speak a somewhat different language from NPD specialists and leaders. I learned the importance of benefit-cost analysis and return on investment (ROI) to prove our department's worth to these organization leaders.

To perform benefit-cost analysis, just use the following formula:

Total benefits / Total costs = Benefit/Cost Ratio

You need to calculate the total benefits of a major program (prevention of ventilator-associated pneumonia) and determine total costs to develop and present the program to calculate the ratio in dollars (<$1=loss, > $1=profit).

For example:  According to the Finance Department, each incident of VAP costs an average of $23,000. The organization had three of these in 2013. After your education, there were no incidents of VAP in 2014. Educators taught 60 critical care nurses pulmonary toileting and proper positioning (HOB up 30 degrees) as VAP prevention techniques in a 1-hour program followed by a check-off of each nurse. Salary numbers used are average salaries and may not be correct for your facility.

The cost of preparing and presenting the education included:

Supplies-Chlorhexidine mouth washes                            no expense to NPD

Educator salary (development) 10 x $35/hr.                     $350

Educator salary (coordination) 6 x $35/hr.                        $210

Educator salary (checkoff)  0.5/hr. x 60 x $35                  $1,050

Salary for admin support 4 x $20                                     $80

Participants’ salaries   1 hr. x 60 x $30/hr.                        $1,800

Total costs                                                                                    $3,490  

Total Benefits    $23,000 x 4 =                                                         $92,000

Using the formula: $92,000 / $3,490 = $26.36 (benefit/cost ratio)              

This indicates a benefit of $26.36 for every dollar spent justifying the time and resources spent to the organization.

The other formula is even better when communicating with Finance experts because it is a language they speak. It's called return on investment and the calculation is:

(Total Benefits - Total Costs / Total Costs) x 100 = ROI

It is always expressed as a percentage. Using the same data as above:

($92,000 - $3,490 / $3,490) x 100 = 2,536%

For every dollar spent, the organization received a return on investment of 2536%. That's phenomenal and certainly demonstrates the value of NPD services!

Using these formulas, especially ROI for 5-10% of your major education initiatives (DeSilets, 2010) in alignment with the organization's strategic plan demonstrates that you are truly an indispensable department and the Finance Department will be one of your biggest boosters.

I wish each of you well on your NPD leadership journey! Now, become indispensable!!

ANPD President's Message

Joan Warren, PhD, RN-BC, NEA-BC, FAAN - President of ANPD

I can’t believe how fast this year has gone! I hope you had an opportunity to participate in our Annual Business meeting webinar.  I’m so proud of all the accomplishments ANPD has made throughout 2015, and I’m excited for the direction that the NPD specialty is headed. The Board of Directors met last week and finalized the 2016-2018 strategic plan, and we are adding the finishing touches before unveiling it in the new year. I believe the plan is very aggressive and robust and will continue to grow and advance our specialty. 

As we prepare for the new year, I want to delve into NPD specialists’ role as leaders in their organizations, a topic that has been top of mind lately. I recently attended several conferences for nurse leaders, educators and staff, each focused on the importance of nursing leadership to advance healthcare and the profession. As you know, ANPD has been working tirelessly to promote the role of the NPD specialist as a leader. Yet, we often do not have or know our organizational data to demonstrate how we impact quality, patient safety, patient experience or contain costs.  In our recent research study, the NPD Organizational Value Demonstration Project, we discovered that the majority of NPD specialists’ time is spent in orientation and mandatory education. Is this the best use of our time and talents as leaders in our organizations? Or would our time be better spent affecting care to improve quality and patient safety while reducing costs and improving patient experience? It is essential that, as NPD specialists, we know where we are spending our time and how our activities are aligned with the mission and vision of the organization. To best ensure our activities are aligned with those of the organization, we must know organizational metrics and understand what keeps our leaders up at night.  With this information, we can align our educational activities with the organization’s goals to position ourselves as leaders. As leaders we need to speak up at meetings about how we can support organizational initiatives and demonstrate irrefutably our value to our organizations.

I encourage each of you to take the leap and put yourself out there! Take a global perspective, know your metrics, and align yourself with the goals and missions of your organization, focusing on quality and patient safety to ultimately result in cost reductions for your organization. And don’t spend all your time in areas that don’t show your true value as a leader.

While I’m excited for this opportunity to talk about our leadership role, I also recognize that we may still have some barriers to achieving it. To promote the role of NPD specialists, your leadership team wrote an article for the Career Sphere column in the American Nurse describing the role of the NPD specialist and how it differs from that of academic nurse educators. In this article, we explain that NPD specialists serve as leaders within their healthcare organizations, as we hold the key to understanding the direction our organization is going. The publication will be out in the near future.

As members of ANPD, we need to have a discussion about how we remove ourselves from activities adding little value and position ourselves as leaders. How do we innovate so we put our energy in the right areas? To foster this conversation, I ask that each of you leave a comment to tell how you have been able to innovate and position yourselves as leaders in your organization. We will post some of the ideas shared in the next issue of our bimonthly newsletter, TrendLines.

Conquering the Forgetting Curve

Cameron Mitchum, MSN, RN-BC, CCRN is a Nursing Professional Development Facilitator in the Professional Nursing Development Department at the Medical University of South Carolina in Charleston.

Most Nursing Professional Development Specialists (NPDS) have, at one time or another, lamented, “But I taught our staff that already!”   In our fast-paced, technologically advanced society, the NPDS may feel we roll large amounts of information out to learners only to have the learner forget it quickly.

The problem with forgetting, however, is not new.

In 1885 Hermann Ebbinhaus developed a mathematical formula to extrapolate a hypothesis of the nature of forgetting. Since Ebbinhaus described his Forgetting Curve his research has been supported and expanded upon by memory experts. 

The speed of forgetting depends on the information's meaningfulness to the learner, how the information is presented, and the nature of the learning barriers which must be overcome. The curve varies little among individuals and the good news is that it can be improved upon.

Spaced Interval Learning is a well-recognized method which has been demonstrated to help learners retain information.  In this model educators provide small amounts of information frequently and over a long period of time.  The results are memories which are retained and retrieved more efficiently.

Massed learning, large amounts of information presented all at once to staff, does not lend itself to easy memory retrieval. Instead of the traditional hour-long class, we can provide small amounts of pre-requisite information in advance of a class.  And instead of listening to a lecture, learners can work together to develop case studies or complete exercises to engage that part of the brain which moves new information into long-term storage.  Over the weeks and months following the class, the NPDS can provide reminders periodically which help to trigger those memories.  Such periodic boosters enhance the neuro-biology of remembering.

While most of us don’t like taking tests, the fact remains that testing is a very effective method to trigger long-term memory. Fill in the blanks, essay, and multiple choice questions offer the learner the opportunity to remember what was learned.   Immediate and long-term testing is a well validated technique to improve memory retention.

We forget quickly.  Neurobiology is the culprit.  We can help people remember by providing small amounts of information, spaced over time, which build upon information.

We can conquer the forgetting curve!