Skill Element Points Acceptable Evidence to Support the Skill Element: Use appropriate templates and submit requested validation if using this criteria for your portfolio Knowledge, Innovations and Improvements Research Project 3 Written verification of active involvement in Research Project. Verification must include your role in the project. (Form C) Evidence Based Practice Project 2 Written verification of active involvement in Evidence Practice Project. Verification must include your role in the project. (Form D) Quality Improvement Project 1 Written verification of active involvement in Evidence Practice Project. Verification must include your role in the project. (Form E) Participation in an approved KentuckyOne Health Nursing Journal club for at least 12 months with documented 75% attendance. 1 maximum Written verification from Journal Club chairperson confirming membership and attendance. Evidence of 4 or more rosters for journal club attendance. Syllabus for one critique presentation. (Form F) Conference Poster Presentation: local, regional =1 pt national =2 pts 2 points maximum Copy of program agenda from conference listing poster and poster abstract. Photo of poster highly recommended. (Form G) Conference Podium Presentation: regionaI conference = l pt national conference = 2 pts 2points maximum Copy of program agenda listing presentation. (Form H) Be a primary writer for a KentuckyOne Health supported endeavor = 1 pt 2 points maximum Written verification from actual grant application with applicant listed as either primary or secondary investigator (Form I) Skill Element Points Acceptable Evidence to Support the Skill Element: Use appropriate if using this criteria
templates and submit requested validation for your portfolio Published article in a professional nursing publication: Regional = 1 Pt (max of 2 pts) National = 2 Pts Book chapter = 3 Pts Book = 4 Pts 1( max 2) 2 pts max 3 pts max 4 pts max Must be listed as an author. Copy of the article from the nursing journal with identifying journal information. (Form N) Award from a professional nursing organization Local/Regional = 1 pt National = 2 pts Maximum of 2 points Copy of professional award (Form O) Participation in a community service activity* of 2 points Written verification of participation from project coordinator/facilitator (Form P) Development/management of a community service activity* *The same community activity cannot be used for both participation and management points 2 (Maximum) Written verification of development/management of activity from project coordinator/facilitator. (Form Q) Participate as a credentialed medical interpreter 1 Must have evidence of class or training attendance as well as validation medical interpreter role (Form R) Participated (assisted) in teaching a class/classes sponsored by the Nursing Education Department 1 of 2 points Written verification from Nursing Education Department to include class name, hours of instruction, date and times of class and CEs, if applicable (Form S) Competency/skills validator Each 4 hours of competency or skills validation = 1 pt of 2 Written verification from Nursing Education Department verifying level of participation including hours spent in the actual validation process. (Form T) Skill Element Points Acceptable Evidence to Support the Skill Element: Use appropriate templates and submit requested validation Check if using this criteria for your portfolio
Be a chairperson/co-chairperson of a unit council with 75% meeting attendance over a 12 month period Be an active participant in a unit council with 75% meeting attendance over a 12 month period 2 --OR— 1 Written verification from Clinical Manager/Director of status and length of time in role. (Form U) Be a champion or superuser for special projects with demonstrated return of information to the unit staff for at least 6 months 1 point each. Maximum of 2 Written verification from Clinical Manager/Director of status and length of time in role. Written verification of activity and dissemination of information. (Form V) Developed an e-learning module (LEARN module) which was published in the LEARN system 1 each. Maximum of 2 Written verification from the administrator to include: goals, title, distribution, date and CEs if applicable. (Form W) Presentation of a case study or patient care conference (facility level or above) 1 each. Maximum of 2 points. Program flyer or attendance roster (Form X) Skill Element Points Acceptable Evidence to Support the Element: Use appropriate templates and submit requested validation Check if using this criteria for your portfolio Exemplary Professional Practice AHA certifications that are not a job requirement: ie, ACLS, PALS, NRP, Stroke 1 point each. Maximum of 2 points. Copy of certification wallet card or active certification credential with expiration date. (Form Y)
Having instructor status and fulfilling minimum instructor obligations in courses utilized by the Nursing Department(if not part of the job role): ie, BLS, ACLS, PALS, NVCI 1 point each. Maximum of 2 points. Copy of certification wallet card or active certification credential with expiration date. (Form Z) Develop and deliver a clinical education program offering CEUs or contact hours 1 point each. Maximum of 2 points. Program flyer with identifying information, attendance roster and summative evaluation (Form AA) Develop and deliver a patient education presentation 1 point each. Maximum of 2 points. Written verification of presentation with date, time, roster, objectives and evaluations (Form BB) Receive a KentuckyOne Health Nursing Award that is presented 4 times a year or less. 1 Copy of Certificate (Form CC) Transformational Leadership Hold office or committee chairmanship in a professional nursing organization (at least a 12 month term): Local/Regional National 1 2 Written verification from Nursing Organization outlining office or committee on the applicant served. Include dates of service. (Form DD) Active committee member in a professional nursing organization (at least a 12 month term): Local/Regional/National 1 Written verification from Nursing Organization committee chairperson outlining office or committee on which the applicant served. Include dates of service. (Form DD) Element Points Acceptable Evidence to Support the Element: Use appropriate templates and submit requested validation Check if using this criteria for your portfolio Active involvement in a KentuckyOne Healthcare facility committee/council for at least 12 months with documented 75% attendance* of 2 Written verification from Committee chairperson confirming membership and attendance. (Form EE) Chairperson/CoChairperson of a KentuckyOne Healthcare facility committee/council for at of 2 Written verification from Committee leadership sponsor confirming membership and attendance. (Form EE)
Chairman: Jerri Passo, MSN, RN, RN-BC Facility Representative Email Phone Continuing Care Hospital Patti Creed 859.967.5176 Flaget Memorial Hospital Jerri Passo fnur.jkp@flaget.com 502.350.5052 Frazier Rehab Institute and Jewish Hospital Downtown Campus Debbie Brown 502.560.8314 Jewish Hospital Ambulatory Group Stephanie 502.259.6806 Jewish Hospital Shelbyville April Li Our Lady of Peace VACANT Saint Joseph Berea Laurie Faught 859.986.6441 Joseph East Tasia Rader 859.967.5718 Saint Joseph Hospital Faith Reynolds 859.313.1765 Saint Joseph Jessamine Michele Rothermund 859.887.6700 Saint Joseph London Cody Dugger 606.303.6920 Joseph Martin Lisa Hall 606.285.6691 Joseph Mount Sterling Roberta Butler Saints Mary & Elizabeth Hospital Melissa Burchett 502.361.6124 University of Louisville Hospital Suzanne Luzama 502.562.3897