Evidence-based professional development initiatives such as certification and clinical ladder advancement can improve nursing knowledge and staff satisfaction and promote team building, henceforth impact patient outcomes. Although review of literature reported a positive impact seen with professional development in the ambulatory setting, challenges such as lack of opportunity and peer coaching were identified.

Purpose: This initiative was developed to support the professional goals of the ambulatory nurses as they work together towards a common goal of professional development mentored by their experienced peers/co-workers.

Objectives
• Increase knowledge and confidence in the ambulatory setting.
• Increase percentage and success in obtaining certification and clinical ladder advancement by monitoring surveys and successful completions.
• Develop coaches and mentors for future programs.
• Improve patient care by monitoring safety and satisfaction reports.

Methods: A pilot initiative of peer-facilitated coaching and mentoring to obtain certification and clinical ladder advancement at the ambulatory care units was developed in the unit council meetings. A steering committee composed of their experienced peers were recruited to develop programs to facilitate and mentor colleagues as well as obtain management support. This committee surveyed the ambulatory nurses, including their managers, to determine interest and support. The survey response was both unanimous and overwhelmingly accepted and requested.

Certification review sessions and clinical ladder mentoring programs were initiated in the ambulatory units and held at a convenient time outside clinic hours and nurses were offered paid “off-unit” time by their managers. The certification review sessions involve small classes which provides overview of the content, test-taking skills, and resources, such as flash cards and practice exams as well as opportunity to partake in the Oncology Nursing Society “free-take program.” The clinical ladder program is also a small class to review requirements and the process. A list of clinical ladder peer mentors is available for guidance during initial development and completion of their project. The steering committee will provide ongoing assistance to the facilitators, mentors, and nurses and develop a mentorship program for nurses interested in becoming future coaches and/or mentors.

Results and goals: In the initial survey, the survey showed that 27 out of 52 (52%) reported not having a certification and 42 out of 52 (81%) reported not having a clinical ladder advancement. All managers supported the programs. To date, 17 nurses have
started the programs: 12 certification and 5 clinical ladder advancement. Our goals are to monitor success of these programs and to increase certification and clinical ladder advancement by 10% within the first year of the program and continue to enhance these programs to reach and maintain at least an 80% certification and clinical ladder advancement. Patient satisfaction scores will be monitored for improvement.

Conclusion: A review of literature revealed that support of professional development through peer coaching and mentoring in the ambulatory setting can have a definite positive effect on the impact of ongoing learning and team-building and may increase patient satisfaction. We hope to accomplish this effect through our initiatives.

Dawn Morrow RN

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