The Nursing Career Advancement and Recognition of Excellence (N-CARE©) Program encompasses the mission and vision of the Department of Nursing at Memorial Sloan Kettering Cancer Center (MSKCC). Our four-tiered clinical career ladder (clinical nurse I-IV), based on Patricia Benner’s theory “From Novice to Expert”, successfully supports the professional development and retention of clinical nurses and advanced degree nurses. The N-CARE© Program ensures that MSKCC’s Department of Nursing recruits and retains top professional nursing talent.
Nurses should schedule the meeting at least three months before submission of application. This meeting will help establish a general timeline for your application requirements and facilitate discussion between the Nurse Leader/Immediate Supervisor and applicant.
Components of the Promotional Process
CNIII and CNIV applications are required to demonstrate the use of CTEP methodology through an evidence-based presentation. Presentations submitted for promotional consideration need to be original content created by the applicant(s) in response to a specific clinical need or practice concern that is relevant to the applicant’s unit/practice. Please refer to the N-CARE© PROGRAM Description for complete details regarding EBP Presentation Requirements.
At the time of their performance appraisal, the nurse will submit the Maintenance Criteria Form to their Nurse Leader for review. This is to ensure that the annual requirements to maintain their level within the N-CARE© Program have been met. A copy of this form will be submitted with the Annual Performance Appraisal to the Nursing Staffing Office.
Evidence Based Presentations are no longer required for CNII and CNIV annual maintenance
P - Patient/Population/Problem
Who is your patient? (Disease or Health status, age, race, sex) / What is the problem?
I - Intervention
What do you plan to do for the patient? (Specific tests, therapies, medications)
C - Comparison
What is the alternative to your plan? (ie. No treatment, different type of treatment, etc.)
O - Outcome
What outcome do you seek? (Less symptoms, no symptoms, full health, etc.)
(T) - Time Frame (Optional)
What is the time frame? (This element is not always included)
Example: In critically ill patients, how does a preventative dressing compared to repositioning affect pressure injury development?
Synonyms for each PICO(T) component:
P: critical care, ICU, immobile
I: preventative dressing, foam dressing, sacral dressing
C: repositioning, standard of care, skin bundle
O: pressure injury, pressure ulcers, skin injury, deep tissue injury
Combine search terms effectively using Boolean operators and logic to create a search strategy.
“AND” logic -- Using AND narrows a search by combining terms
“OR” logic -- Using OR broadens a search to include results that contain either of the words
(critical care OR ICU) AND (preventative dressing OR foam dressing) AND (pressure injury OR pressure ulcers)
Below are some additional searching tips that can help broaden or narrow the results retrieved. These are more advanced searching techniquies and should be used if your initial search strategies are not identifying what you want or need.
Phrase Searching - May be done with double quotes (“ “)
Truncation - Add an * to the end of a root word to look for variations of the word
Subject Headings - Controlled vocabulary can be used in certain databases
(“Critical Care” OR ICU OR Immobile OR “Critically ill”) AND (“foam dressing” OR “sacral dressing” OR “Wound care”) AND (reposition* OR “skin bundle”) AND (injury OR ulcer* OR “pressure ulcer”)
This search strategy can be copied and pasted directly into the databases you chose to search.
Identify three (3) databases that are appropriate for searching on your topic/question. Below are many of the popular databases available through the MSK Library.
Know what the database is best for and chose those matched to the topic you are searching.
|Nursing/allied health literature
|Biomedical literature; international; drug, disease, device focus
|Joanna Briggs (JBI)
|Systematic Reviews and EB practice recommendations and summaries
|Systematic Reviews and clinical trials
|Web of Science
|Multidisciplinary; good for searching for similar citations; identify references and cited bys of citations
|Validated Health and Psychosocial Instruments/Tools/Surveys
|Behavioral health/psych literature
|Clinical search tool designed to rapidly identify the highest quality clinical evidence
Below are some of the most popular MSK databases to use for N-CARE EBP presentations.
PubMed: PubMed comprises more than 29 million citations for biomedical literature from MEDLINE, life science journals, and online books. Links are available from PubMed to full text articles (Fulltext@MSK) provided by the MSK Library.
CINAHL (Cumulative Index for Nursing & Allied Health Literature): Covers nursing, biomedicine, alternative/complementary medicine, consumer health, and the allied health fields. It offers access to health care articles, books, nursing dissertations, selected conference proceedings, standards of practice, educational software, and audiovisual materials.
Embase: A comprehensive international bibliographic resource with millions of records from journals, conferences, and non-English publications in the biomedical and pharmaceutical fields.
Joanna Briggs Institute (JBI): JBI EBP Database allows you to simultaneously search a wide range of summarized and appraised health care evidence across seven publication types including Evidence Based Recommended Practices, Evidence Summaries, Best Practice Information Sheets, Systematic Reviews, Consumer Information Sheets, Systematic Review Protocols, and Technical Reports.
It should be able to be replicated by someone else.
Requirements for keeper articles:
In your presentation you must summarize each keeper article by including the following:
When to seek assistance from your nurse mentor/educator:
When to see assistance from the library/librarian: