Nursing Education and Nursing Services: Best Partners for Best Practice

SCCEN Annual MeetingNovember 11-13, 2012

Lauren R. Goodloe, PhD, RN, NEA-BC, Director Medical and Geriatric Nursing, Administrative Director for Nursing Research of VCU Health System & Assistant Dean for Clinical Operations VCU School of Nursing, Richmond, VANancy F. Langston, PhD, RN, FAAN, Dean VCU School of Nursing & Executive Director for Academic Nursing VCU Health System, Richmond, VA

Richmond on the James

Experiment inProgress

Vision For The PartnershipBest Partners for Best Practices

A formal structural partnership will create a synergy for continuous quality improvement in both the education and practice of nursing. Furthermore, it will advance an organizational model consistent with the underlying philosophy of operation of an academic Health Sciences Center as a component of a university.

Living Next Door to one another or within the same

university does not a partnership make!

Academic-Service Partnerships are not

simply Hospital-School Affiliations

Academic-Service Partnerships

• Many Models• Academic Medical Center Models• Hospital-Community Partners Models• Blended Models

Academic-Service Partnerships

• There are as many possible ways to formulate academic-service partnerships as there are potential partners

• Partnerships are about trusting, open relationships and ongoing communication, joint planning and day to day operations

• Recognize what your individual strengths are and what you can do better as partners

• Beware of “Power Struggles”

Story of One Partnership Model

• Early meetings and Discussions• Start with a small very committed group of

people• Must include the Dean and CNO• Must include people who will work through

the details and day to day operations• Must have committed leaders/cheerleaders

who will carry the vision into ACTION

Create Preferred Futures

Nursing is

Knowledge WorkKnowledge Work

Nurses are not DOERS who happen to thinkBut areTHINKERS who also do

10/19/08

Environment that EMBRACES AND

LIVES LIFE LONG LEARNING

Position Titles For The PartnershipNursing Services Primary – School of Nursing

VP Patient Care services & CNO of VCU Health Systems (VCUHS) AND Associate AND Associate Dean for Clinical Programs, SONDean for Clinical Programs, SON

Director of Medical and Geriatric Nursing AND Assistant Dean for Clinical Operations, AND Assistant Dean for Clinical Operations, SONSON

Director of Education and Professional Development AND Assistant Dean of AND Assistant Dean of Continuing Education, SONContinuing Education, SON

Dean of VCU School of Nursing AND Executive AND Executive Director for Academic Nursing, VCUHSDirector for Academic Nursing, VCUHS

Associate Dean for Academic Programs AND AND Director of Academic Nursing, VCUHSDirector of Academic Nursing, VCUHS

Associate Dean for Doctoral Program and Research AND Director of Clinical Research and AND Director of Clinical Research and Evidence based Practice, VCUHSEvidence based Practice, VCUHS

Extension Of Appointments Within The Partnership

Nursing Services School of Nursing

All nurses who advance to Clinical Nurse V are automatically appointed as Affiliate Faculty of the School of Nursing

PhD prepare nurses Affiliate AND Adjunct faculty appointments

Approximately 40 VCUHS nurses a semester serve as adjunct faculty of the School

Nursing Faculty who desire are provided practice appointments equivalent of up to a day a week – appointments range from Critical Care through Geriatric Ambulatory Clinic

FOUR Joint Appointments between Service and Education created

Outcomes of our Partnership

WORKFORCE DEVELOPMENT

EDUCATIONAL INITIATIVES AND CURRICULUM DEVELOPMENT

SHARED RESOURCES

ENHANCED COMMUNICATION AND MUTUALITY REGARDING SHARED GOALS, ISSUES AND CONCERNS –internal and external to our system

TRANSFORMATION OF AN ORGANIZATION’S CLIMATE

Outcomes of our Partnership

WORKFORCE DEVELOPMENT •Expanded number of BS graduates – both entry level and RN to BS – received financial support from VCU Health System for 6 faculty positions for support of expansion of the entry level track and has continued to support 3 positions

10/12/12

8/99,12/99,5/00 8/04,12/04,5/05 8/11,12/11,5/12

BS traditional 76 122 141

RN to BS 90 109 155

MS & post MS 80 72 82

PhD 3 5 14

Total 249 308 392

NUMBER OF GRADUATES

Outcomes of our Partnership

WORKFORCE DEVELOPMENT Expanded number of BS graduates – both entry level and RN to BS – received financial support from VCU Health System for 6 faculty position for support of expansion of the entry level track and has continued to support 3 positions.

Developed systems of personnel support from nursing students as care partners through PhD graduates as nurse scientists

Nursing Students as VCUHS Care Partners Spring, 2012 Of the 170 care partners 85 were VCU Nursing Students

16 PhD Nurse Scientists at the Health System

Outcomes of our Partnership

WORKFORCE DEVELOPMENT •Expanded number of BS graduates – both entry level and RN to BS – received financial support from VCU Health System for 6 faculty positions for support of expansion and has continued to support 3 positions

•Developed systems of personnel support from nursing students as care partners through PhD graduates as nurse scientists

•Implemented the UHC/AACN nurse residency program for new baccalaureate graduates and currently working toward CCNE accreditation of the program.

Number of new Nurse UHC/AACN Residents 2006-2010 and Number who were VCU Graduates

Residents VCU SON Graduates

2006 60 432007 51 322008 77 692009 86 652010 94 752011 125 952012 136 84Total 629 463

Outcomes of our Partnership

WORKFORCE DEVELOPMENT •Expanded number of BS graduates – both entry level and RN to BS – received financial support from VCU Health System for 6 faculty positions for support of expansion and has continued to support 3 positions

•Developed systems of personnel support from nursing students as care partners through PhD graduates as nurse scientists

•Implemented the UHC/AACN nurse residency program for new baccalaureate graduates and currently working toward CCNE national accreditation of the program;

•Created a climate that inspires nurses to continue their formal educational preparation and recently adopted a policy that requires all new AD prepared employees to become enrolled in an accredited BS nursing program within 2 years and obtain the BS degree within 5 years of initial employment;

Number of VCUHS Staff Enrolled in School at VCU SON

Outcomes of our Partnership

WORKFORCE DEVELOPMENT•Developed systems of personnel support from nursing students as care partners through PhD graduates as nurse scientists

•Expanded number of BS graduates – both entry level and RN to BS – received financial support from VCU Health System for 6 faculty positions for support of expansion and has continued to support 3 positions

•Implemented the UHC/AACN nurse residency program for new baccalaureate graduates and work toward national accreditation of the program;

•Created a climate that inspires nurses to continue their formal educational preparation and recently adopted a policy that requires all new AD prepared employees to become enrolled in an accredited BS nursing program within 2 years and obtain the BS degree within 5 years of initial employment;

•Added new rung on Clinical Ladder (Clinical Nurse V) for nurses in direct clinical care built upon competencies of graduate education

Creation of Clinical Nurse V Levelon The Clinical Ladder

Keeping MS Prepared Nurses At The Bedside

Clinical Nurse V Criteria

• Years of practice – 5+• Certification status – Must be certified• Education level: MS in Nursing• Involvement in professional organization• Focus on EBP • Strong “leadership” roles• Submit for publication of article/poster/podium

presentation• Affiliate faculty for VCU SON

Outcomes of our PartnershipEDUCATIONAL INITIATIVES AND CURRICULUM DEVELOPMENT •Developed a Nursing Administration and Leadership clinical concentration within the master’s program. •Created a perioperative internship in response to request from and work with colleagues in perioperative nursing – extended to add upper division electives AND use of the perioperative area as one of the clinical placements for students in the senior level acute care course. •Created a Nursing Research Fellowship Program•Developed an evidence-based practice internship and fellowship

Outcomes of our PartnershipEDUCATIONAL INITIATIVES AND CURRICULUM DEVELOPMENT •Developed a Nursing Administration and Leadership clinical concentration within the master’s program.

•Created a perioperative internship in response to request from and work with colleagues in perioperative nursing – extended to add upper division electives AND use of the perioperative area as one of the clinical placements for students in the senior level acute care course.

•Created a nursing research fellowship program

•Developed an evidence-based practice internship and fellowship

•Co-sponsor an annual summer camp for diversity pipeline development

Outcomes of our Partnership SHARED RESOURCES

•VCU Health System supported faculty positions for enrollment increase•Joint Council and Committee Membership•Use of Clinical Learning Center for staff orientation and continuing competence •Joint Capital Campaign for new building – hospital created payroll deduction for contributions

Nursing Education Building

School of Nursing BuildingPhoto: Alain Jaramillo

Outcomes of our PartnershipENHANCED COMMUNICATION and MUTUALITY REGARDING SHARED GOALS, ISSUES, AND CONCERNS internal and external to our system.

Student, staff and faculty concerns addressed immediately – not waiting until . . . . . . end of semester

Political, legislative and regulatory “ONE VOICE” from VCU

Outcomes of our PartnershipTRANSFORMATION OF AN ORGANIZATION’S CLIMATE

Nursing and nurses as knowledge workers has been made visible and valued within the structures of the organizations

Creation of a climate that has at its essence life long learning – for all parties at all times The climate on the hospital units embraces all nurses responsibility for creating a positive learning environment and experiences for the nursing students. We actually talk about “a dedicated educational hospital” among ourselves and with others.

There is no us/them, we/they - it is ONLY US

Validation of our PartnershipMagnet recognition citation of the partnership as a major strength – initial and re-certification

VCU School of Nursingand

VCUHS Nursing Services

X2The relationship between the School and

Nursing Services was cited by the site visitors as a significant strength of the application for

Magnet status

Validation of our PartnershipNLNAC 2009 reaccreditation site visit report cited the partnership and the depth and breadth of adjunct faculty as a strength of the School

Virginia Board of Nursing 2011 site visit report cited the strength of the partnership and the adjunct faculty relationship

Validation of our Partnership$1,250,000 gift from the VCU Health System to the School of Nursing to establish a Center for Quality Patient Outcomes housed in the School of Nursing - building upon this partnership to expand across other academic units.