Central Valley Coalition

The Nursing Leadership Coalition of the Central San Joaquin Valley

January 23, 2017

Dear Nurse Leader:

Since 1997, nurses of the Central San Joaquin Valley have been honored with the distinguished NLC RN of the Year Award. This prestigious award event, attended by nurse leaders, hospital administrators and physicians who support professional nursing in our valley, will be held on Thursday, May 11, 2017 at 5:30 pm at Fresno City College Cafeteria, 1101 E. University Avenue, Fresno, CA 93741.

We invite you now to nominate a Registered Nurse who has made outstanding contributions to the profession of nursing, locally or globally. We will recognize individuals in various areas of nursing practice, and an awardee will be selected in each of the following categories:

Best Practice Awards:

Excellence in Leadership : This award is given to recognize, document and communicate best practices in Administration. Examples include, but are not limited to: leadership in clinical decision making, staff development, physician collaboration, nurse/family interaction, shared governance. Nominees should occupy a nursing leadership role in healthcare or academic institute.

Excellence in Education: This award is given to recognize, document and communicate best practices in Education. Nominees should occupy a role in which they contribute to staff, patient or student education. This may include service or academic leaders. Examples include, but are not limited to: service-academia partnerships, excellence in educational program development or innovative education practice.

Excellence in Clinical Practice: This award is given to recognize, document and communicate best practices in clinical nursing. Nominees should be a direct care provider who demonstrates leadership in improving clinical nursing practice. Examples include, but are not limited to: programs that promote professional nursing practice and impact direct care providers, or evidence-based practice research that is translated into clinical practice improvements.

Innovation in Professional Nursing: This award is given to recognize, document and communicate innovations in the delivery of patient care. Examples include, but are not be limited to improvements in patient safety, workflow efficiency, staff satisfaction, quality outcomes, contributions to the promotion of human welfare, population health management and/or fiscal responsibility among staff.

Excellence in Nursing Research: Awarded to a nurse who has made significant contributions to research that expands the body of knowledge and supports evidence-based practice.

Awards for Support of Professional Nursing:

Friend of Nursing: Awarded to an individual or organization demonstrating significant contributions and support for the nursing profession. Examples include: creation of a center of clinical excellence, funding support for nursing programs and/or projects or support of a professional organization that promotes Nursing.

of 5 A Registered Nurse may be nominated in one of the best practice categories. A past nomination does not excl ude the individual from being nominated again. The RN nominee should be an individual who has excelled in his or her service to the profession of nursing and to the community.

It is important that you provide a robust nomination application, reflecting the applicant’s contributions in several areas, including but not limited to his/her unit, department, organization, community, etc. We strongly suggest that you interview your applicant so that he/she can provide detailed information on background and contributions, both within the nursing profession and the community. Please provide enough information about the candidate to give the selection committee a complete picture of the candidate’s accomplishments.

The deadline for nomination submission is March 10, 2017. There will be no submissions accepted after that date.

Submit a nomination at the NLC website (http://www.nlc.wildapricot.org) by:  completing the application  submitting the application fee of $50.00  submitting a photo of the nominee (jpeg format) to [email protected]

Additionally, we would like to extend an invitation to you and your nominee’s colleagues to attend the banquet i n support of your nominee. Submit reservations and payment on the NLC website. Also available at the NLC website are the Program Advertisement and Sponsorship forms. Please consider this opportunity to support n ursing. Feel free to contact one of us at [email protected] for more information.

Sincerely,

Gloria Fitzgerald, RN Co-Chair, NLC RN of the Year Committee

of 5 2017 RN of the Year Nomination Worksheet Submit all applications on line at http://www.nlc.wildapricot.org

Applications and fees must be submitted by the nomination deadline of March 10, 2017 to be considered for selection. Dinner reservations are required by April 30, 2016 for $40 per person. Dinner reservations after April 30th are $50 per person. All reservations are required by May 5, 2017.

1. Category of nomination (select one):______

A. Excellence in Leadership : This award is given to recognize, document and communicate best practices in Administration. Examples include, but are not limited to: leadership in clinical decision making, staff development, physician collaboration, nurse/family interaction, shared governance. Nominees should occupy a nursing leadership role in healthcare or academic institute. B. Excellence in Education: This award is given to recognize, document and communicate best practices in Education. Nominees should occupy a role in which they contribute to staff, patient or student education. This may include service or academic leaders. Examples include, but are not limited to: service-academia partnerships, excellence in educational program development or innovative education practice. C. Excellence in Clinical Practice: This award is given to recognize, document and communicate best practices in clinical nursing. Nominees should be a direct care provider who demonstrates leadership in improving clinical nursing practice. Examples include, but are not limited to: programs that promote professional nursing practice and impact direct care providers, or evidence-based practice research that is translated into clinical practice improvements. D. Innovation in Professional Nursing: This award is given to recognize, document and communicate innovations in the delivery of patient care. Examples include, but are not be limited to: improvements in patient safety, workflow efficiency, staff satisfaction, quality outcomes, contributions to the promotion of human welfare, population health management and/or fiscal responsibility among staff. E. Excellence in Nursing Research: Awarded to a nurse who has made significant contributions to research that expands the body of knowledge and supports evidence-based practice.

2. Name of nominee: Address: Home Phone: Work Phone:

3. Current RN license number and expiration date:

4. List Degrees:

of 5 5. List Current Certifications:

6. List last 10 years of nursing experience, most recent position first. Please do not use abbreviations:

Dates Organization Position

7. List previous recognition for performance and/or service in the profession of nursing:

Date Award

8. List previous recognition for performance and/or service in the community and/or church:

Date Award

Provide supporting evidence or examples of how the nominee has achieved recognition for this Best Practice Award

Describe the nominee’s involvement at the unit and/or organizational level. (Examples may include councils, performance improvement projects, research studies, patient safety activities, etc.). (300 words max.)

Describe how the nominee supports the profession of nursing practice and the delivery of quality care. (300 words max.)

of 5 Describe how the nominee provides leadership at the unit, organizational and community level. This may include evidence of how the nominee supports and empowers others to influence nursing. (300 words max.)

Describe the nominee’s involvement in professional nursing organizations. Include positions held currently and in the past. (300 words max.)

Describe the nominee’s commitment to professional development, for himself/herself and others. (300 words max.)

Describe the nominee’s contributions to advancing the profession of nursing. This may include involvement in nursing research, evidence-based practice changes, publications, presentations, etc. (300 words max.)

Please provide a short bio that will be used during the RN of the Year Ceremony with a 100 words or less, as the nominator to complete to capture the nominees title, accomplishments and reason for the nomination.