Digital Repository Masters Projects Spring 2024 Training Mentors to Increase Nurse Participation in a Clinical Nurse Ladder Program Nicole Nickerson Weber State University Follow this and additional works at: https://dc.weber.edu/collection/ATDSON Nickerson, N. 2024. Training Mentors to Increase Nurse Participation in a Clinical Nurse Ladder Program Weber State University Masters Projects. https://dc.weber.edu/collection/ATDSON This Project is brought to you for free and open access by the Weber State University Archives Digital Repository. For more information, please contact scua@weber.edu. WSU REPOSITORY MSN/DNP Training Mentors to Increase Nurse Participation in a Clinical Nurse Ladder Program Project Title by Nicole Nickerson Student’s Name A project submitted in partial fulfillment of the requirements for the degree of MASTERS OF NURSING Annie Taylor Dee School of Nursing Dumke College of Health Professions WEBER STATE UNIVERSITY April 26, 2024 Ogden, UT Date Nicole Nickerson, BSN, RN, MSN Student 4/26/2024 Student Name, Credentials (electronic signature) Date Anne Kendrick, DNP, RN, CNE 4/26/2024 MSN Project Faculty Date (electronic signature) 4/26/2024 (electronic signature) DNP, N, CNE MSN Program Director Note: The program director must submit this form and paper. Date 1 Training Mentors to Increase Nurse Participation in a Clinical Nurse Ladder Program Nicole Nickerson Annie Taylor Dee School of Nursing Weber State University NRSG 6802 Integrating Scholarship Into Practice Dr. Anne Kendrick April 26, 2024 2 Abstract Purposes/Aims: This project aims to develop a mentor-training program for nurses who have completed a clinical nurse ladder (CNL). Nurses who complete the CNL may attend mentor training to facilitate other nurses' participation in the CNL. Rationale/Background: CNLs are linked to increased retention, better patient outcomes, increased evidence-based practice (EBP), and less nurse burnout. One Magnet-designated hospital in Intermountain Health wanted to increase nurse participation in EBP. A CNL is an evidence-based solution for increasing EBP. Methods: A PowerPoint training module and surveys were developed to facilitate the training of mentors. The training also introduces specific resources for the hospital’s CNL to increase the mentor’s comfort level when assisting nurses participating in the CNL. Results: Three major themes arose in the literature about nursing mentors. Mentors 1) facilitate EBP implementation, 2) increase engagement and participation in professional development opportunities such as certification, and 3) training and developing mentors is crucial. Conclusions: Implementing a mentor training program can allow nurses to gain valuable knowledge and skills and increase their confidence as they mentor staff. A mentor training program can have multiple benefits, including increased CNL participation, engagement, EBP, retention, and lower burnout among nurses. Keywords: evidence-based practice, clinical nurse ladder, engagement, certification, mentor 3 Training Mentors to Increase Nurse Participation in a Clinical Nurse Ladder Program Nursing has a higher turnover rate than the national average (Mijares & Radovich, 2020). According to the National Nursing Workforce Survey (2022), 800,000 nurses have indicated that they plan to leave healthcare within the next five years. Healthcare leaders must find ways to attract, develop, and retain nurses while providing high-quality patient care in light of the nursing shortage. Professional growth and development opportunities such as a clinical nurse ladder (CNL), specialty nursing certification, and training in evidence-based practice (EBP) have the potential to increase nurse engagement, decrease burnout, and improve retention (Melnyk et al., 2021). Participation in professional development activities has several barriers, such as fear of failure, uncertainty about completing the necessary steps, and lack of proper support (Winslow & Blankenship, 2007). However, mentors can play an essential role in the professional development of other nurses. In one qualitative study, nurses reported obtaining a specialty certification because another nurse they looked up to was certified (Wei et al., 2023). Mentors are shown to facilitate higher satisfaction and lower rates of burnout among nurses (Drury et al., 2022). Statement of Problem Magnet is the American Nurses Credentialing Center's [ANCC] (n.d.) recognition of hospitals where nurses are empowered to innovate, lead, and implement new knowledge using EBP. In 2023, an Intermountain facility was designated with Magnet status, and several other hospitals were on the Magnet application journey. Magnet facilities must submit an application for redesignation every four years with supporting documentation of continued Magnet culture, EBP, and nurse-led research and innovation (ANCC, n.d.). The CNL is a pathway that hospitals 4 can implement to empower nurses to practice EBP, gain certification, and increase the professional development of clinical bedside nurses. This pathway will help the hospital succeed in Magnet recognition and redesignation. Despite the CNL's financial reward and evidence-based professional growth opportunities, nursing participation in the CNL is low, with only one outpatient nurse completing the ladder in its first year. This project aims to use the existing CNL and existing hospital CNL champions but add CNL mentor training to increase nurse participation in the program. If CNL completion rates rise, then hospital rates of certified nurses, EBP-trained nurses, and involvement in quality improvement and research will also increase. These outcomes achieve multiple goals. First, nurses will be more satisfied and likely to stay, and a CNL makes recruiting easier (Warman et al., 2016). Secondly, the culture of empowered nurses involved in quality improvement and research will aid in EBP engagement, fostering a culture that will aid in Magnet redesignation. Significance of Project Facilities that have a high level of EBP are more likely to have a Magnet designation (Saul et al., 2022) and have nurses who report higher job satisfaction (Mijares & Radovich, 2020), improved patient outcomes, lower costs, and increased nurse engagement (Melnyk et al., 2020). One practical approach to increase engagement, job satisfaction, EBP, and foster professional growth opportunities is the implementation of a CNL. The CNL can provide a pathway for professional development, specialty certification, and implementation of evidencebased practice (Watts, 2010). Using the existing CNL at Intermountain called iAspire and unit champions, this project will develop a mentor training program for CNL champions to attend so they can confidently guide other nurses through the CNL, provide access to resources, and encourage their participation. 5 Review of the Literature This literature review aims to identify how formal mentor training can increase a mentor's confidence in being a resource for outpatient nurses interested in professional growth opportunities, such as the clinical nurse ladder. The PICOT question for this literature review is: In clinical nurse ladder programs, how does formal mentor training as compared to no training affect the CNL mentor's comfort level for guiding outpatient nurses through the program? Framework The Iowa Model of Evidence-Based Practice is a versatile framework nurses developed to bring EBP to the bedside (Buckwalter et al., 2017). The Iowa Model consists of seven steps that begin with a "trigger" event, such as a clinical question or identified problem. The next steps of the Iowa Model are developing a PICOT question, forming a team, and synthesizing evidence. The last three steps include developing and piloting the change, integrating the change, and disseminating the knowledge. Nurses involved in EBP activities can improve patient outcomes and decrease nurse burnout (Spiva et al., 2017). In a qualitative study by Speroni et al. (2020), 90% of the respondents reported using the Iowa Model as the framework for EBP implementation, research, and teaching in their nurse residency. Mudderman et al. (2020) stated that the Iowa Model provides a standard process to develop EBP education. For several reasons, the Iowa Model was selected as the framework for mentor training to increase participation in professional development activities. Applying the Iowa Model is appropriate because it allows for a step-by-step application from the issue of low participation in professional development to the training of mentors and, finally, a dissemination of the project results. The trigger event for this project is low participation in evidence-based professional 6 growth opportunities for nurses. Strengths and Limitations A strength of the Iowa Model is the focus on team formation early in the process. Early identification and involvement of key stakeholders is essential (Buckwalter et al., 2017). Ideally, the team is formed in the nursing unit for ultimate buy-in. When change is proposed by frontline staff, there is less adversity to change versus when it is imposed by administration (Doody & Doody, 2011). Additionally, the Iowa Model is versatile and can be used by frontline caregivers, educators, and administrators. The framework also uses bulleted points so users can individualize the steps to meet their needs (Buckwalter, 2017). A limitation of the Iowa Model framework is that it is a long process with seven steps that must be followed. Sometimes, following many steps can be a deterrent to implementing EBP. Another limitation of the Iowa Model is that many CNLs are built on Benner's Novice to Expert Model, which was considered for this project. Benner's Model is a solid framework when determining the stages of a CNL. Still, it was not chosen for this project since Intermountain has an existing framework, and this project focuses on increasing participation in the CNL through the training of mentors. Analysis of Literature Despite best efforts and good intentions, evidence-based practice is challenging to implement. Wei et al. (2023) stated that it takes 17 years to implement new knowledge into daily practice. When new research on quality care and EBP is available, it must be quickly implemented to guarantee the best possible care. Many tools have been developed to implement EBP, but one stands out: the use of mentors. Search Strategies 7 A search of current literature was conducted using keywords and a Boolean combination of the words mentor, nurse, nursing, EBP, evidence-based practice, pediatric nurse certification, and certification. Search filters were set for peer-reviewed articles for the years 2013-2023. Initially, a five-year search was conducted, but some substantial research was ten years old but still acted as the basis for current research, so the search criteria were broadened to include them. CINAHL, PubMed, Weber State's One Search were searched. Hand searching was also utilized for additional relevant articles. Synthesis of Literature This literature review revealed three major themes. The first theme is the importance of mentors in facilitating EBP implementation. The second theme in the literature is that mentors increase engagement and participation in professional development opportunities such as certification. The third theme focuses on the process of developing mentors. Mentors Play an Important Role in EBP Implementation Nurses may value EBP, but barriers exist that prevent the implementation of EBP (Mudderman et al., 2020). In Mulkey's (2021) expert opinion, common obstacles to EBP include a lack of EBP knowledge and skill, support, time, and resources. Stavor et al. (2017) also listed a lack of mentor and organizational support as barriers to EBP implementation. When institutions lack support for EBP, nurses are likely to report the lack of support as a significant barrier to EBP implementation (Melnyk et al., 2021). Blok et al. (2022) conducted a survey revealing that nurses may feel their role isn't valued, turnover is too high, and lack of leadership support and physician engagement as barriers to EBP implementation. A study at a critical access hospital concluded that EBP mentors effectively increased EBP knowledge and practice (Mudderman et al., 2020). The hospital made a practice change throughout the facility following the study. Time 8 and resources were dedicated to the EBP training and mentor program, which required management and organizational support. Mentors are a significant factor in successful EBP implementation. A 2018 U.S. study of 2,344 nurses found that EBP competency is significantly associated with EBP mentors (Melnyk et al., 2018). Lott et al. (2020) found that EBP mentors help improve EBP knowledge, attitude, skill level, and organizational readiness for EBP. Mentors can increase participation in EBP activities, improving quality and patient safety and reducing healthcare costs. Nurses' EBP competencies increased with the support of mentors, and the number of EBP projects quadrupled within the first six months of EBP mentoring. Nurses benefit from EBP mentors as healthcare organizations aim to implement and sustain EBP (Spiva et al., 2017). There are opportunities to increase EBP implementation. In a survey of 51 nurses working in a rural hospital, five facilitators to EBP were identified: administrative support, availability of professional resources, nurse manager support, incentives for professional development, and mentoring of people with research experience (Stavor et al., 2017). These facilitators of EBP were also identified by Blok et al. (2022) with the addition of access to data, education, and training in quality improvement, culture, and nursing ownership. Lott et al. (2020) identified mentoring as having the strongest association with EBP competency. Nurse mentorship development improves the nurses' confidence in their ability to implement EBP after training. Duff et al. (2020) explained that evidence-based change is most effective when frontline staff can provide input and be involved in the change process. The alignment of the organization's mission with evidence-based change also positively correlated with its adoption. After implementing EBP mentors, Lott et al. (2023) found that nurses' attitudes toward EBP and their EBP knowledge and skills increased. 9 Duff et al. (2020) described four critical themes for an EBP environment. First, a process that includes a shared EBP model, implementation guides, and a focus on frontline nursing were identified as necessary steps. Second, EBP training, support, and a stepped approach to EBP education were discussed. Third, leadership, management, and expertise were essential for EBP. Lastly, context or culture is associated with successful EBP implementation. Mentors Increase Nurse Engagement Through Certification Professional development opportunities increase nurse satisfaction and employment retention. Obtaining a specialty certification allows nurses to increase participation in professional development (Mijares & Radovich, 2020). Nursing certification benefits patients, nurses, and organizations. Certified nurses are more likely to deliver EBP, improving patient outcomes. Certified nurses are also more satisfied (Edwin, 2022). Given the benefits of certification, the ANCC Magnet also values certification and requires organizations to have a plan to increase certification (Wei et al., 2023). Clinical ladders can effectively engage nurses, leading to higher satisfaction and retention rates, but participation in the program tends to be low (Mijares & Radovich, 2020). Mentors are essential for organizations to increase rates of certification among nurses. Wei et al. (2023) suggested that organizations can promote professional development and specialty certification by pairing nurses with a certification with non-certified ones. Mijares and Radovich (2020) used a mentor model to increase nurse participation in professional development activities offered through their CNL. Through the mentor model, there were 167 mentors trained with a 27% advancement within their CNL. Tucci et al. (2022) found that staff reported barriers in the CNL process, such as completing the application, writing requirements, and registering for required education. After 10 implementing a study group and some other operational changes, a survey of 64 nurses in 2022 found that 86% were satisfied with the CNL. Mulkey's (2021) quality improvement project examined how to engage nurses in research and quality improvement. It was determined that participation in research activities, collaboration with a mentor, and a CNL with a research component led to increased job satisfaction. Leaders and the support they offer for EBP are essential contributors to EBP. Nurse managers and leaders can support an EBP mentor culture by allowing time and resources dedicated to projects, EBP training, and mentor training programs (Lott et al., 2020). This type of transformational leadership can positively affect EBP adoption and success. Spiva et al. (2017) suggest that leaders incorporate EBP into annual reviews, make EBP a job requirement, add EBP to the clinical nurse ladder, provide EBP toolkits, and support conference attendance and presentations as ways to support EBP. Consistent recognition of EBP accomplishments should be provided (Melnyk et al., 2018). Celebrating nurses and their success can be motivating for others, such as badges that can be used to signal their certification. Other forms of recognition include names on a plaque, prizes, and celebrating National Certified Nurses Day (Edwin, 2022). Development of Mentors for Professional Development of Others Mentorship may be a formally or informally defined relationship between the mentor and mentee (Grossman, 2012). Hospitals may use a mentor program to formally train mentors in EBP and the skills needed for mentoring to increase nursing participation in EBP. Saul et al. (2022) reported that hospitals with a formal research mentor had significantly higher scores on the Hospital-Based Nurse Research Characteristics survey. Formal mentoring programs benefit the organization because a framework for sharing knowledge, building relationships, and improving communication can improve engagement and retention (Miller et al., 2020). 11 To implement a formal mentorship program, an organization needs to commit to and support mentors and mentor training (Mijares & Radovich, 2020). A study of 66 mentors found that mentor training that included didactic instruction, discussion, in-person training, and online training increased the nurse mentor's confidence, skills, and attitudes toward EBP. They also found that nurses had increased EBP knowledge when they had access to online EBP training and access to a mentor (Spiva et al., 2017). After mentor training, nurse mentors self-reported increased confidence in locating resources and training materials and implementing EBP interventions (Lott et al., 2020). Winslow and Blankenship (2007) implemented a formal mentored CNL "club." They implemented a computer training component to give an overview of the CNL and prepare initial documents. There was a facilitated discussion about each CNL element. Since the start of the CNL club, more nurses have participated in the CNL than seen in the past 20 years. Spiva et al. (2017) reported that nurses who attended EBP mentor training had significantly higher confidence, perception of knowledge and skill, and attitude related to EBP utilization. Mentees who participated in structured mentor training reported professional growth, making a difference, and less burnout (Drury et al., 2022). With only about 35% of healthcare systems having a formal mentorship program, there remains a gap in adopting nurse mentorship programs in hospitals (Mijares & Radovich, 2020). Mentors can impact the implementation of evidencebased practice, improving patient outcomes and nurse retention. Summary of Literature Review Findings and Application to the Project The literature review highlighted the importance of EBP implementation for patient safety and improved quality outcomes. Additionally, nurses working at organizations with a culture supporting EBP have higher job satisfaction reports (Melnyk et al., 2021). Despite the 12 benefits of EBP for patients and nurses, significant barriers remain to implementing EBP. Stavor et al. (2017) identified a lack of EBP mentors as a barrier to EBP implementation. To increase nurse participation in EBP, hospitals may use a mentor program to formally train mentors in EBP and develop the skills needed for mentoring. In implementing a formal mentorship program, an organization needs to commit to and support mentors and mentor training (Mijares & Radovich, 2020). Mentors can guide nurses through EBP implementation and professional growth opportunities such as the clinical ladder to improve retention and decrease burnout. Project Plan and Implementation This MSN project aims to create training to develop CNL mentors to increase participation in the organization's clinical ladder. According to Mijares & Radovich (2020), clinical ladders can effectively engage nurses, leading to higher satisfaction and retention rates, but they tend to have low participation rates. CNL programs that lack a mentor component may be underused because nurses don't feel supported or that they have enough resources or knowledge to complete the program successfully. Trained mentors can lead peers more effectively through the CNL journey, beginning with the letter of intent and continuing through completing an e-portfolio. Mentorship programs are shown to decrease turnover, increase job satisfaction, and improve workplace cohesion (Drury et al., 2022). The project plan and implementation process, interdisciplinary team, description and development of project deliverables, and timeline are further discussed in this section. Plan and Implementation Process Developing and implementing a mentor training program for the CNL will use the Iowa Model, which was selected as the framework for mentor training to increase participation in 13 professional development activities and EBP. This project aims to train mentors to gain the skills, knowledge, and confidence to guide mentees through the CNL. This CNL nurse mentor program will pair a mentor who has completed the CNL with a mentee for one year. The mentor must meet specific criteria, including a recommendation from a clinical nurse excellence team member, successful completion of at least level 2 in the CNL, and be employed by the organization. The mentee must be a nurse who meets the eligibility requirements for the CNL. After nurses express interest in mentoring to their manager or educator, or fill out the mentor form, they will be offered mentor training. The mentor training will consist of two onehour online training workshops. During the workshops, they will learn about the benefits of mentoring and the skills needed for successful mentor relationships. During the final day of mentor training, iAspire resources will be reviewed to help the mentor know what is available and how to help the mentee find answers throughout the process. Pre- and post-surveys will be administered before the first workshop and after the last workshop to understand better the impact of the materials, education, and skills learned. Interdisciplinary Team Organizations and employees can both benefit from a CNL. Employees participating in CNL are more likely to stay and have higher job satisfaction (Mijares & Radovich, 2020). The CNL has been available to nurses within Intermountain Health for a year. Unfortunately, the CNL was not widely publicized within the organization when it was rolled out, and nurses and managers reported needing clarification about the point system and navigation within the program. Creating a team of mentors, along with support and training, aims to improve CNL participation. 14 Stavor et al. (2017) identified administrative support, availability of professional resources, nurse manager support, incentives for professional development, and mentoring of people with research experience to be facilitators of EBP. The stakeholders for this project include the clinical nurse excellence team, which oversees the CNL, nurse managers, nurses, and previous CNL participants. Nurse Managers. Nurse managers are vital to the professional development of nurses. Time, resources, and additional support are required as nurses learn new skills, attend training, and work on projects. Nurses interested in the CNL must have their nurse manager sign a letter of intent to participate in the CNL. The nurse manager may also be asked to assist the nurse with time to work on approved projects, attend meetings, provide professional development training, and support EBP implementation. Nurse managers can also help the nurse identify projects aligning with the unit's quality goals (Lott, 2020). Nurse managers can also support the program's long-term success by emphasizing the importance of the nurse's involvement in EBP and improvement during check-ins and evaluations (Spiva et al., 2017). Nurse managers are also vested in a successful CNL program because when nurses are engaged, they will have improved retention (Drury, 2022; Mijares & Radovich, 2020). Frontline Nurses. Nurses participating in a CNL report higher intent to stay (Mijares & Radovich, 2020). Getting frontline nurses to overcome their fears and participate in CNL is challenging. Each CNL level with a monetary gain has requirements for EBP. Many nurses report barriers to EBP and may be afraid of the barriers to learning and implementing EBP. Mentors can alleviate some of these fears and encourage nurses to choose a CNL level that they feel is achievable. Lott et al. (2020) reported a 300% increase in nurse-led EBP projects when there was a mentorship program. 15 Nurses who Have Participated in the Clinical Nurse Ladder. Mentoring has a positive impact on the mentor as well as the mentee (Mijares & Radovich, 2020). Change is more widely accepted when it is proposed by frontline staff, and there is less adversity to change versus when it is imposed by administration (Doody & Doody, 2011). Frontline nurses as mentors are central to this MSN project. The goal of the Nurse Excellence team is to have one champion from each facility advocating for the CNL. This project aims to attract and retain at least one nurse from each unit at an Intermountain Health hospital. Clinical Nurse Excellence Team. The CNL was developed and is overseen by the clinical nurse excellence team. Their team comprises of nurses specializing in EBP, research, education, and mentorship. They will participate in the mentor training program, track CNL completion rates, and survey mentors and mentees. The clinical nurse excellence team oversees submissions for Magnet stories, assists with abstract writing and submissions, and runs many EBP training programs that CNL participants can take to increase proficiency in EBP. Magnet stories will be generated as nurses participate in the CNL, learn EBP, and complete projects with their unit manager. The role of the clinical nurse excellence team is that they are vital stakeholders in this project. Their support can facilitate the successful implementation of the mentor program at one facility and the program's expansion to other facilities within the organization struggling with low CNL participation. Description and Development of Project Deliverables The deliverables for the CNL mentor training will include (a) a pre and post-survey to assess the mentor's comfort level in mentoring, (b) a questionnaire about their experience going through the CNL, (c) a PowerPoint presentation defining mentorship and outlining the benefits of mentoring to be used during a Teams mentor training, (d) breakout group discussions during 16 the Teams training facilitated by members of the Nurse Excellence team, (e) a "get to know you" form to be used for future matching of mentors with a mentee, and (f) a sequence of follow-up emails communicating with the mentors one and three months following the training. iAspire Mentor Training PowerPoint. The first project deliverable is a PowerPoint presentation (see Appendix A). The PowerPoint for mentor training is intended for iAspire leadership stakeholders to outline the benefits of mentoring and provide an overview of what a mentoring program would include. The PowerPoint starts with an overview of mentorship, the benefits of mentoring, and how mentoring differs from preceptorship and coaching. Mentor support is needed to be successful, and support often comes from a strong framework and leadership support. The PowerPoint discusses multiple ways that mentors can be supported. Next, the PowerPoint discusses different aspects of iAspire that the mentor training will include. One barrier to CNL participation is not knowing where to find materials, access resources, and connect with peers. The training will review the resources for abstract writing, the e-portfolio, how to contact a medical librarian, and review online resources such as Teams and the iAspire website. The PowerPoint also discusses training topics specific to mentoring, such as active listening, giving feedback, and goal setting. Lastly, the PowerPoint ends with how to recognize mentors through regular check-ins, spotlights in a newsletter, and a luncheon for mentors to connect with each other and leadership. Mentor Interest Form. The second deliverable for this project is a mentor interest form (see Appendix B). There is a QR code on the iAspire Mentor flyer (see Appendix C). The short form gathers important information, such as contact information through work email and which CNL program they completed. The form aims to create a network and database of people who express an interest in learning to become a mentor. 17 iAspire Flyer. The third deliverable is a flyer for iAspire (see Appendix C). It includes information about the benefits of mentoring and connecting with peers. A QR code that links to the Mentor Interest form is included at the bottom of the flyer. The colors chosen for the flyer use Intermountain Health's new brand theme and were created to be visually appealing and easy to read. Pre-Mentor Training Survey. The short pre-mentor training survey (see Appendix D) was designed to be filled out quickly to increase survey responses. The same questions are used in the post-mentor training survey (see Appendix E) to compare data about the training materials, delivery, and methods used for mentor training. The objective is to increase the participants' confidence to mentor, role model, and obtain iAspire resources. If there is little to no change between the pre- and post-surveys, then the training materials, delivery, and information will be adjusted. Post-Mentor Training Survey. The post-mentor training survey (see Appendix E) is longer than the pre-survey because questions about the learning activities and the participant's expectations are included. Two questions on the pre-survey are repeated in the post-survey to compare participants' confidence in mentoring, role modeling, active listening, and accessing resources for iAspire. Timeline The development and implementation of this project will take about one year. The reason for the longer project timeline is due to Intermountain Health's standardization of clinical ladders across the system in early 2024. It will take some time to adjust to the new CNL, allow nurses to become acquainted with it, and provide adequate time to mentor nurses through the first and second cohorts of the CNL. The timeline (see Appendix F) starts in quarter one of 2024 and ends 18 in quarter one of 2025. With the announcement of iAspire in February 2024, the CNL will have significant changes for nursing. There will be a Town Hall led by nursing leadership to introduce iAspire and explain the requirements for participation. In March 2024, the PowerPoint presentation will be presented to unit managers and the clinical nurse excellence team. If the mentor project is approved, flyers will be distributed during unit staff meetings and huddles and in the Primary Promise Newsletter to find nurses interested in mentoring. In quarter three of 2024, the mentor training will be held online, and nurse mentors will be added to the online database of mentors. Mentors are searchable in Workday, an online program Intermountain Health uses for human resources, education, career development, and professional goals. When people become mentors within the organization, their profile and contact information is listed in Workday, and others are able to search for them. Mentors and mentees will connect and begin discussions about iAspire, requirements, and project ideas. During quarters one and two of 2025, the mentors and mentees will be asked to present their project progress and experience working together. Hopefully, more nurses will be inspired to connect with a mentor and try iAspire. A luncheon will be held to celebrate both mentors and mentees in the spring of 2025. Project Evaluation This MSN project will be evaluated in several ways. First, the pre- and post-mentor training surveys will provide feedback regarding the participant's perception of the effectiveness of the mentor training. The post-survey will also be sent three months later to see if the training outcomes continued to be successful. An additional evaluation of the project will be the number of nurses who submit a letter of intent for the CNL in 2024 and complete the iAspire program in 2025. The outpatient clinic 19 employs 80 nurses and had one nurse apply and complete the CNL in 2023. This project can also be evaluated by the number of nurses who work with a mentor and decide to try the CNL. Projects must be uploaded to an e-portfolio to be reviewed by the iAspire committee. Following nurses' completion of iAspire, a committee member would reach out to the nurse through an email survey to gather data about whether they used a mentor and their experience with iAspire. If no answer is received through the email survey, the nurse will be contacted by phone. The data will be gathered and examined to determine how many nurses worked with a mentor and if they felt the mentor assisted their learning and impacted their likelihood of finishing the CNL. Ethical Considerations An ethical consideration with this MSN project is the mentor and mentee pairing. The iAspire mentor team aims to create a mentor and mentee match that fosters learning, communication, and shared goals. However, there will inevitably be conflict, and a framework for addressing it needs to be established. Conflict may arise from a mismatch in personality, goals, expertise, or other reasons. The mentor and mentee are encouraged to speak up early if they feel a mismatch. Open communication and mutual respect can help overcome the anxiety one may have when requesting a different pairing. Confidentiality is another ethical consideration. Neither the mentor nor mentee should share the other's personal goals, struggles, or concerns with peers, friends, or others. If the mentor or mentee has concerns about performance, attendance, or other issues, they should first discuss them with each other, followed by a discussion with the manager. The pre- and postmentor training results will be anonymous to encourage honest feedback. The anonymous results will be available to the mentor training program facilitators and organizers. Reports on the data 20 will be run and analyzed using Excel, and the information will be stored securely on the system’s encrypted drive. The gathered and analyzed data will be used to improve future training. The mentor-mentee relationship is not a supervisory one. The mentee is not required to change practice, blur boundaries, or do tasks or projects that they feel jeopardize patient safety or their license. At any time, the mentor or mentee can speak up if they feel uncomfortable. Another ethical consideration of this project is the availability of mentor training to anyone interested. The training program is designed to train mentors to increase their confidence in guiding nurses through the CNL. However, the training can apply to many areas within the hospital and outside of nursing. Employees who want to receive mentor training can attend this mentor training or be provided with resources for mentor training within the organization. Discussion Mentors are an effective way to engage, retain, and connect team members. Mentoring benefits the mentor, the mentee, and the organization. Organizations benefit from formal mentor training programs. As knowledge is shared, relationships are built, and communication increases, employee engagement and retention improve (Miller et al., 2020). Mentees who participated in structured mentor training report professional growth, making a difference, and less burnout (Drury et al., 2022). This section of the paper will discuss the dissemination of the project, as well as its implications, recommendations, and conclusions. Evidence-based Solutions for Dissemination Intermountain Health has standardized the CNL in 2024 across the system. iGrow was the CNL used for the past couple of years in a few facilities, and there were other CNLs throughout the system. A new standardized CNL program, iAspire, has been released to all Intermountain Health facilities as a pilot program. Since there is yet to be data about iAspire, one 21 solution for data gathering is to pilot mentor training outcomes by surveying nurses who complete iAspire and comparing the results to sites that do not have CNL mentor training. Hence, having data about how to institute a CNL, assess engagement, and collect data about completion rates will be valuable in evaluating the effectiveness of iAspire. This MSN project will be disseminated during monthly manager meetings. Additionally, unit educators and shared leaders will be educated, too. The project PowerPoint will also be reviewed and discussed at a monthly iAspire champion meeting. The poster presentation for this project will be presented to Weber State University students and teachers. It may be presented at a local nursing conference if well received. Implications Implications for this MSN project include increasing nurse engagement, developing professional networking connections, and encouraging nurses to practice and refine leadership skills. As iAspire is introduced, this project is well-positioned to generate excitement and participation in the program. Furthermore, this project will build on the existing mentor resources within the organization and create a framework to support nurses' professional growth and development. This project has several limitations. First, iAspire is a new program, so understanding the specific concerns and challenges may be difficult in the first year. Mentors may spend more time exploring barriers, given the nature of a new program, which is more complicated than previous iterations of the CNL. Another barrier for this project is the sample size. There was very little utilization of the CNL program, so finding nurses available to mentor may be challenging. The first year of having mentors may involve more leadership and education staff members until clinical staff have the opportunity to complete training and the CNL. 22 Recommendations Examining the research for this project revealed plenty of information about mentoring and CNL separately, but there needs to be more evidence about specific mentoring strategies through a CNL. The implementation of this project is based on the evidence available. However, an area of opportunity to further this project is to research and implement how to teach to different learning styles, teach and evaluate how to mentor diverse populations, and how to match mentors and mentees best using an evidence-based method. Conclusions Implementing a CNL can increase engagement, job satisfaction, EBP, and foster professional growth opportunities. If CNL completion rates rise, then hospital rates of certified nurses, EBP-trained nurses, and involvement in quality improvement and research will also increase. However, there are barriers to completing a CNL. Therefore, organizations may consider implementing a mentor program to facilitate CNL participation and completion. Implementing a mentor training program can allow nurses to gain valuable knowledge and skills and increase their confidence as they mentor staff. After mentor training, nurse mentors self-reported increased confidence in locating resources and training materials and implementing EBP interventions (Lott et al., 2020). If implemented, the mentor training program would have multiple benefits, including increased CNL participation, engagement, EBP, retention, and lower burnout among nurses. 23 References American Nurses Association (n.d.). Mentorship in nursing: Benefits and why it is essential. Retrieved October 22, 2023 from https://www.nursingworld.org/resources/individual/benefits-of-mentorship-in-nursing/ American Nurses Credentialing Center's [ANCC] (n.d.). About Magnet. Retrieved from https://www.nursingworld.org/organizational-programs/magnet/about-magnet/ Buckwalter, K. C., Cullen, L., Hanrahan, K., Kleiber, C., McCarthy, A. M., Rakel, B., Steelman, V., Tripp, R. T., & Tucker, S. (2017). Iowa model of evidence-based practice: Revisions and validation. Worldviews on Evidence-Based Nursing, 14(3), 175–182. https://doiorg.hal.weber.edu/10.1111/wvn.12223 Doody, C. M., & Doody, O. (2011). Introducing evidence into nursing practice: Using the IOWA model. British Journal of Nursing, 20(11), 661–664. https://doi.org/10.12968/bjon.2011.20.11.661 Drury, Z., Kotobalavu, C., Hofmann, L., & Austria, M.J. (2022). Examining the effects of a structured mentorship program on the nurse mentor: A pilot study engaging oncology nurses. Clinical Journal of Oncology Nursing 26(1), 27-30. https://doi.org/10.1188/22.CJON.27-30 Edwin, H.S. (2022). Strategies to increase nursing certification. A progressive care certification for nurses-pathway for success. Journal for Nurses in Professional Development. 39(5), E112–E118. https://doi.org/10.1097/NND.0000000000000874 Grossman, S.C. (2012). Mentoring in Nursing: A dynamic and collaborative process. Springer. 24 Hancock, L.M. (2022). Implementation and evaluation of a cloud-based, evidence-based nurse mentor training program. Journal for Nurses in Professional Development 38(2), 82-87. https://doi.org/10.1097/NND.00000000000007 Lott, F.L., Hughes, R.G., & Johnson, E. (2020). The implementation of an evidence-based practice mentoring program. Nursing Management 51(4), 1114. https://doi.org/10.1097/01.NUMA.0000657292.87970.06 Melnyk, B. M., Gallagher-Ford, L., Zellefrow, C., Tucker, S., Thomas, B., Sinnott, L. T., & Tan, A. (2018). The first U.S. study on nurses' evidence-based practice competencies indicates major deficits that threaten healthcare quality, safety, and patient outcomes. Worldviews on Evidence-Based Nursing, 15(1), 16–25. https://doi.org/10.1111/wvn.12269 Melnyk, B.M. & Fineout-Overholt, E. (2019). Evidence-Based Practice in Nursing and Healthcare (4th ed.). Wolters Kluwer. Melnyk, B. M., Zellefrow, C., Tan, A., & Hsieh, A. P. (2020). Differences between magnet and non-magnet-designated hospitals in nurses' evidence-based practice knowledge, competencies, mentoring, and culture. Worldviews on evidence-based nursing, 17(5), 337–347. https://doi.org/10.1111/wvn.12467 Melnyk, B.M., Tan, A., Hsieh, A.P., & Gallagher-Ford, L. (2021). Evidence-based practice culture and mentorship predict EBP implementation, nurse job satisfaction, and intent to stay: Support for the ARCC model. Worldviews on Evidence-Based Nursing 18(4), 272281. https://doi.org/10.1111/wvn.12524 Mijares, A., Radovich, P. (2020). Structured mentorship and the nursing clinical ladder. Clinical Nurse Specialist 34, 276-281. https://doi.org/10.1097/NUR.0000000000000558 25 Miller, C., Wagenberg, C., Loney, E., Porinchak, M.P., & Ramrup, N. (2020). Creating and implementing a nurse-mentoring program. A team approach. The Journal of Nursing Administration 50(6), 343-348. https://doi.org/10.1097/NNA.0000000000000895 Mudderman, J., Nelson-Brantley, H., Wilson-Sands, C., Brahn, P. & Graves, K. (2020). The effect of an evidence-based practice education and mentoring program on increasing knowledge, practice, and attitudes toward evidence-based practice in a rural critical access hospital. JONA: The Journal of Nursing Administration, 50(5), 281-286. https://doi.org/10.1097/NNA.0000000000000884 National Council of State Boards of Nursing [NCSBN] (2022). National nursing workforce study. Retrieved from https://www.ncsbn.org/research/recent-research/workforce.page Saul, T., Rangel, T., & Sperry, M.V. (2022). Influence of a formal mentor on hospital-based nurse research resources and outcomes. The Journal of Nursing Administration 52(10), 549-553. https://doi.org/10.1097/NNA.0000000000001197 Speroni, K. G., McLaughlin, M. K., & Friesen, M. A. (2020). Use of evidence-based practice models and research findings in magnet-designated hospitals across the United States: National survey results. Worldviews on Evidence-Based Nursing, 17(2), 98–107. https://doi.org/10.1111/wvn.12428 Spiva, L., Hart, P.L., Patrick, S., Waggoner, J., Jackson, C., & Threatt, J.L. (2017). Effectiveness of an evidence-based program mentor training program. Worldviews on Evidence-Based Nursing 14(3), 171- 251. https://doi.org/10.1111/wvn.12219 Tucci, R., McClain, B. & Peyton, L. (2022). Beyond a clinical ladder. The Journal of Nursing Administration, 52(12), 659-665. https://doi.org/10.1097/NNA.0000000000001228 26 Watts, M. (2010). Certification and clinical ladder as the impetus for professional development. Critical Care Nursing Quarterly, 33, 52-59. https://doi.org/10.1097/CNQ.0b013e3181c8e333 Wei, H., Haddad, L.M., Nwokocha, T.A., Powers, M., Wei, A., Carroll, Q., & Ballard, N. (2023). Organizational culture and roles in promoting nurse specialty certifications: A qualitative study in the United States. International Journal of Nursing Sciences, (10), 189-198. https://doi.org/10.1016/j.ijnss.2023.03.003 Winslow, S., & Blankenship, J. (2007). Mentoring clinical ladder advancement with a facilitated prep class. Journal for Nurses in Staff Development 23(4), 180-182. https://doi.org/10.1097/01.NND.0000281417.42849.c8 27 Appendix A Mentor Training PowerPoint Mentor Training Overview NICOLE NICKERSON, BSN, RN JANUARY 21, 2024 Training Course Topics What is mentorship? Benefits of mentors Supporting mentors Review of resources 28 What is Mentorship? Mentorship Benefits Different From Caring relationship with one another Overcome barriers Preceptor Close the gap from academic to practice Clinical Coach Bringing together different goals and strengths to produce an outcome greater than the sum of its parts Allows sharing of knowledge and teaching with one's peers (Beard et al., 2021) Support system for newly hired nurses Instructor (Mijares & Radovich, 2020) Allows senior nurses an opportunity to pass on organizational and institutional knowledge Develop leaders (Beard et al., 2021) Why is Mentor Training Important? u Increased clinical nurse ladder participation (Mijares & Radovich, 2020) u Increased evidence-based practice (Lott et al., 2020) u Benefits the mentor and the mentee u Better outcomes, improved patient safety, and lower costs (Lott et al., 2020) u Increases engagement u Mentors can increase retention 29 Supporting Mentors u u Leadership support § Clinical Nurse Excellence Team § Mentor Network within Intermountain Health § Nursing leadership Mentor training is professional development § Time and resources u Healthy work environment (Mijares & Radovich, 2020) u Strengthens the nursing profession iAspire Resources u Updated website u Teams channel u E-Portfolio u Assistance with writing abstracts u Medical librarian support u Newsletter 30 Mentor Training Topics u Active listening u Goal Setting u Giving feedback u Mentoring people who are different than you u Work-life balance u Challenges and obstacles in mentoring Training Outline Workshops Mentor Community Additional Resources E-workshop online training (two, 1hour training courses) Support system of other mentors with monthly meetings to discuss progress and review topics from the initial workshop Access to iAspire experts for training and clarity on each level for iAspire • Led by Clinical Nurse Excellence team Evidence-based mentor training Resources for each topic are presented with accompanying discussions facilitated by the instructor Opportunity to connect with leadership Step-by-step instructions for each level of iAspire Review of current projects Networking with nursing from outside facilities Review of hospital committees Office-hours for each iAspire level to share barriers EBP mentor provided for project assistance Access to current QI projects 31 Recognition u An important part of having mentors is recognizing them u Hold regular check-ins with the mentors to assess their wellbeing u Annual luncheon for mentors and mentees u Spotlight in the hospital newsletter References Blake-Beard, S., Shapiro, M., Ingols, C. (2021). A model for strengthening mentors: Frames and practices. International Journal of Environmental Research and Public Health, 18(12), 6465. https://doi.org/10.3390/ijerph18126465 Lott, F. L., Hughes, R. G., & Johnson, E. (2020). The implementation of an evidence-based practice mentoring program. Nursing Management 51(4), 11-14. https://doi.org/10.1097/01.NUMA.0000657292.87970.06 Mijares, A., Radovich, P. (2020). Structured mentorship and the nursing clinical ladder. Clinical Nurse Specialist 34, 276-281. https://doi.org/10.1097/NUR.0000000000000558 32 Appendix B Mentor Interest Form 2/3/24, 10:30 AM Mentor Training Interest Mentor Training Interest Thank you for your interest in mentor training. We will reach out with more information. 1. Name 2. Have you completed a level in iGrow or iAspire? Yes No 3. Work email This content is neither created nor endorsed by Microsoft. The data you submit will be sent to the form owner. Microsoft Forms https://forms.office.com/Pages/DesignPageV2.aspx?origin=NeoPortalPage&subpage=design&id=DQSIkWdsW0yxEjajBLZtrQAAAAAAAAAAAAMAAOob_ItU… 1/1 33 Appendix C iApsire Mentor Training Flyer iAspire MENTOR TRAINING Mentoring increases communication skills, creates connection, knowledge sharing, and engagement (Miller et al., 2020) BENEFITS Learn new skills Grow professionally Advance your career Network with peers RESOURCES Become familiar with resources for iAspire Remove barriers and assist peers with the application and CNL process (Tucci et al., 2022) CONNECT Mentoring benefits the mentor and the mentee (Mijares & Radovich, 2020) Coach, develop, and learn INTERESTED? Scan the QR code to fill out a form to express your interest in mentor training 34 35 Appendix D Pre-Mentor Training Survey 2/3/24, 10:29 AM Pre-Mentor Training Survey Pre-Mentor Training Survey * Required 1. How would you rate your confidence in mentoring a peer through iAspire? 1 2 3 4 5 6 7 Poor 8 9 10 Excellent 2. How do you agree with the following statements? * Extremely disagree Somewhat disagree I feel skilled in active listening. I feel confident that I know where to find resources for iApsire I feel confident that I can be a role model Being a mentor will help me grow professionally This content is neither created nor endorsed by Microsoft. The data you submit will be sent to the form owner. https://forms.office.com/Pages/DesignPageV2.aspx?origin=NeoPortalPage&subpage=design&id=DQSIkWdsW0yxEjajBLZtrQAAAAAAAAAAAAMAAOob_ItU… 1/2 36 Appendix E Post-Mentor Training Survey 37 38 Appendix F Mentor Training Timeline