Document Type


Original Publication Date



Presented at:

  • 2019 Odyssey Conference: Educating the Acute & Critical Care Nurse, March 12, 2019, VCU Health, Richmond, VA
  • 2019 Pathways to Knowledge Nurse Educator Conference, April 26, 2019, VCU Health, Richmond, VA

Date of Submission

August 2019


Problem Statement:

Low participation in challenging the Clinical Ladder within the Perioperative Surgical Services was observed. The period 2016-2017, only five nurses from the department challenged and were successful on the ladder. As a process improvement initiative, the department implemented CLEPPS, using the organization’s clinical ladder program as a tool.


It is documented in the literature that a robust Clinical Ladder Program increases staff satisfaction, enhances professional development, and improve patient outcomes.

The Perioperative Surgical Services has a total of 102 Clinical Nurse II within the department who were eligible for advancement on the clinical ladder. An internal survey, Research Electronic Data Capture (RedCap) was created to learn why the staff was not challenging the clinical ladder. Survey analysis revealed an experienced group of nurses within the department that have the background to challenge the ladder. Many feel that the clinical ladder process is involved, complicated, and daunting, but staff also feel that the clinical ladder would provide them with a sense of accomplishment or professional satisfaction. The CLEPPS program was launched based on feedback to provide staff with more encouragement, information, and work time support in compiling a portfolio to challenge the ladder.


  • Identify high performing clinical nurses to challenge the clinical ladder
  • Provide information through presentations, department newsletter, email, and program brochure
  • Provide customized binder with details of the advancement process including application forms
  • Provide classes-“an introduction to portfolio development classes,” and five “pulling it together” sessions with CE credits


The goal of 12 nurses was set to challenge the ladder. Thirteen nurses were successful. Employees through self-discovery are submitting their portfolio best practices and feel more valued because of support from leaders. Part II of the project is data collection on job satisfaction and retention rates. These can be measured through a satisfaction survey and department external turnover rates data.


This poster is distributed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) License (

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VCU Health Nursing

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Nursing Commons