Evaluation of clinical ladder in postoperative and critical care units

An evaluation study of
Clinical Ladder among nurses
and nurses administrators in
postoperative and critical care
units
Ann-Marie Storsveen
ICU educational nurse
Generell intensiv, Rikshospitalet
Oslo University Hospital

• The purpose of the Clinical Ladder
• Background
• The program
• Evaluation study
• Conclusion

The purpose of the Clinical Ladder
• To guide participants developing their clinical
expertise at the patient bedside
• The program do not aim to formal education to
specialize nurses in intensive care, nor to
achieve an academic degree, but rather a further
clinical development of skills for the nurses who
want to stay bedside

Background
• The program was initiated in1995 by the
Norwegian Nurses Organisation (NNO) and
made it possible for nurses to apply to become a
clinical specialist.
• Our Division of Critical Care, Rikshospitalet
developed a local version suitable for our group
of patients
• Onset local Clinical Ladder in ICU 2001

1 Level 1
1
The Clinical Ladder
2
3
Level 2
Level 3
2
3
4
4 Clinical Specialist

Evaluation of the Clinical Ladder Program
Methods
• Questionnaire to all 241 nurses in the ICUs.
• Focus group interviews with a total of 15 ICU
clinical nurse specialists.
• Interview of the ICUs’ nurse administrators : Each
ward was represented by two nurse
administrators

Survey respondents
• Response rate 135/241 - 55%
• Trained nurses with more than 10 years
experience = 108
• ICU specialized nurses = 121
• More than 3 years employment in the current ICU
= 88
• more than 10 years employment in the ICU = 25

Questionnaire content
For the nurses participating in the program
-What are the reasons for participating in the clinical ladder
program
-What experiences have the participants made during the
program period
-How did the participants use their new skills
-How did the nurses evaluate the different learning methods
in relation to contributing to their professional
development
For the nurses who did not participate in the program
-What are the reasons for not participate in the clinical
ladder
-Do you plan to participate in the Clinical Ladder at a later
occasion

Results
• The nurses rated the desire for personal and professional
development as the main reason for participating in the CL
• Clinical specialists experienced increased professional
integrity and increased self-esteem.
• The clinical specialists looked forward to get the opportunity
to use their new competence
• Engagement from the nurses administrators and follow up
by the educational nurses were important factors for the
positive result
• The nurse leaders viewed the Clinical Ladder as a tool in
developing nursing quality and to recruit and keep the
nurses engaged in the unit
.

Conclusion
The results indicate that the Clinical Ladder
Program in the ICU is a very positive factor for
professional development for nurses.
The conclusion of this evaluation study is that
competence program is recommended

Siv Stafseth (prosjektleder)
CCN, MNSc
Mette Tøien
AN, MNSc
Ann-Marie Storsveen
CCN
Mona Austenå
CCN
Tove Gjellum
CCN
Hanne Alfheim
CCN, MNSc
Lise Merete Alpers
CCN, MNSc
• Siv Stafseth (prosjektleder)
• CCN, MNSc
• Mette Tøien
• AN, MNSc
• Ann-Marie Storsveen
• CCN
• Mona Austenå
• CCN
• Tove Gjellum
• CCN
• Hanne Alfheim
• CCN, MNSc
• Lise Merete Alpers
• CCN, MNSc
THANK YOU
for your
attention!