Implementation of nursing services in community corrections: A community-academic partnership

Persons who are incarcerated (PWAI) suffer from a disproportionately higher number of physical and mental health conditions. While most jails and prisons provide onsite healthcare, community correctional centers often do not and accessing community healthcare is challenging due to insurance issues, inadequate health literacy, mistrust, and long waits for appointments. A registered nurse-led wellness clinic provides a viable solution to addressing the healthcare needs of PWAI in a community correctional setting. Through a community-academic partnership between a college of nursing and two community correctional transitional centers for men, a registered nurse (RN) faculty member and nursing students provide onsite healthcare. Services include, but are not limited to, acute and chronic disease management, case management, healthcare navigation, and health education. In the first 2 years of operation, there have been 587 new resident health assessments, 882 RN visits, and 152 group education sessions. RN visits have been primarily for: connection to resources (42.6%), medication management (15.6%), and acute conditions (12%). A RN-led wellness clinic is an innovative way to address health needs for PWAI. While this model of care focuses on an academic RN faculty practice at community correctional centers it could be replicated across community settings.     

Educating the nursing workforce in 2000 and beyond

Changes in the health care delivery system have comparable impacts on both nursing practice and education, such that tomorrow's nursing practice would best emanate from innovative partnerships between leaders in practice and education. For the foreseeable future, an expert nursing workforce is needed in an expanded form, but an array of challenges to maintaining this workforce are evident. Recent and continuing scientific and technologic advances in health care make the matching of practice and education to evolving trends paramount. Regardless of what the future holds, generative leadership in any realm of practice is essential to move our profession into the forefront of health care.     

Academic–Practice Partnerships for Community Health Workforce Development

Despite increasing attention to academic–practice partnerships for health practice and workforce development, guidelines for how to implement such partnerships are few. The Kansas Public Health Workforce and Leadership Development (WALD) Center provides a successful example of such a partnership. The WALD Center implements public health education and training projects through a collaborative process of health needs identification, program conceptualization, research, and program evaluation. Such coordination allows for continuous practitioner-oriented program development and the sharing of a rural state's scarce resources between interconnected projects. The WALD Center's methods provide a model for academic–practice partnerships for community health practice and workforce development, even in environments with scarce health resources.     

Implementing innovation through education-practice partnerships

Calls to transform the healthcare system and evolve the preparation of healthcare professionals have increased in recent years. In response to the concerns and recommendations voiced in the series of national reports, the American Association of Colleges of Nursing (AACN) Board of Directors initiated a series of task forces from 1999-present. The pilot Clinical Nurse Leader (CNL(trade mark)) initiative which grew out of the work of the task forces represents an exemplary national partnership between nursing education and practice. The CNL is a new nursing role being developed and piloted by the AACN in collaboration with education and practice leaders. An AACN task force, comprised of equal representation from education and practice, is currently working with 86 partnerships, including 92 schools of nursing and 191 health care institutions, to implement the CNL initiative. All of the partnerships have committed to collaboratively develop a master's CNL degree program and to transform one or more units within the healthcare institution utilizing the new CNL role. Early patient care outcomes from the initiative are positive. However, one additional outcome realized from the initiative has been the coming together of nursing education and practice to achieve a common goal-improved patient care outcomes.     

A present-day academic perspective on the Carolina nursing experience: Building on the past,shaping the future

Past, present, and future models of academic-service collaboration are described and projected from an academic perspective. The features that characterize academic-service partnerships during the history of nursing education in America, the goals that drove faculty and academic leaders to engage or disengage in earlier partnerships, and new forms of emerging partnerships are presented, along with a discussion of their importance in the context of environmental change. The foundation for building the Carolina Model between the University of North Carolina-Chapel Hill and the University of North Carolina Hospitals is a prototype for extending future academic-service initiatives.     

Transforming RN roles using an academic-practice partnership to improve healthcare access for underserved populations

There is a national call to improve healthcare access for underserved populations by preparing BSN students to practice at the full scope of their license in community-based, integrated primary care settings upon graduation. In response to this call, a robust academic-practice partnership—using interprofessional education and practice and primary care and leadership development— is preparing BSN students to practice in community-based integrated primary care settings where culturally diverse rural and urban underserved populations receive care. In this article, academic-practice partners describe the implementation, lessons learned, and initial outcomes of a grant-funded program that is transforming nursing education and practice. All partners viewed communication, collaboration, and flexibility as key to a successful partnership. Our work serves as a template to help others shift nursing culture to create a sustainable RN workforce prepared to improve the health and wellbeing of underserved populations.     

Medicare funding for nursing education: proposal for a coherent policy agenda

Medicare Graduate Medical Education (GME) funding for nursing education, established in 1965, no longer represents a coherent policy agenda, which must support educating the nursing workforce from classroom to practice. Three key concepts must be addressed: nursing education costs for both service and educational institutions, defining nursing education in federal rules and regulations, and the community's role in supporting nursing education. Responsibility for educating a nursing workforce must be shared by the community of academic, health care, professional, and government institutions and organizations, a policy supported by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO). Knowledge about costs, funding streams, and policies for nursing education is essential for nursing educators to advocate for funding of nursing education and practice. Nursing programs and academic institutions need to initiate discussions with policy makers and potential community partners about service/education partnerships. Finally, community investment in nursing education pays dividends by providing essential health services of a highly skilled professional workforce.     

The academic‐practice gap: Strategies for an enduring problem

The academic‐practice gap in nursing is well documented. Academe is criticized for producing nurses insufficiently prepared to fully participate in patient care. Practice settings are criticized for having unrealistic expectations of new graduates. This article is based on a review of the literature and an exploration of contemporary practices used to bridge academic and practice partnerships. Differences in outcome expectations for new graduates between academe and practice are outlined and consequences of the gap for new graduates, patients, and employers are discussed. Five specific strategies to address the gap are discussed, with the primary realm and responsibility for two falling to education, one to practice, and two to both. Strategies discussed include increased use of simulated learning in nursing education; disruptive innovations in education that promote learner‐centered active learning; extended orientation/Transition to Practice Programs for new graduates; dedicated education units; and academic service partnerships. Current literature suggests the viewpoints of academic and practice leaders continue to appear divergent. Closing the gap will require a dedicated and coordinated response from both academe and clinical practice.     

Clinical nursing and midwifery education in the pandemic age

The COVID-19 pandemic has disrupted clinical nursing and midwifery education. This disruption has long-term implications for the nursing and midwifery workforce and for future healthcare responses to pandemics. Solutions may include enhanced partnerships between schools of nursing and midwifery and health service providers and including schools of nursing and midwifery in preparedness planning. These suggestions notwithstanding, we call upon national and international nursing and midwifery bodies to study how to further the clinical education of nurses and midwives during pandemics and other times of crisis.     

Utilizing Academic–Service Partnerships to Advance the Care of Veterans

Challenges encountered in both advanced practice registered nursing (APRN) education and veteran health care include an aging workforce, limited resources, and faculty/staff shortages, which ultimately affect patient outcomes. Academic–service partnerships (ASP) address these challenges by increasing workforce capacity and engagement, promoting interprofessional collaboration and evidence-based practice, creating educational opportunities for nursing students to work with underserved populations, and offering a mechanism for recruitment and retention. This article outlines the systematic approach a large doctor of nursing practice (DNP) program in the southwestern United States used to develop and deploy an ASP program with 2 sizeable veteran-serving community partners.     

Who will teach the nurses of the future?

The authors predict that if the number of nursing faculty does not increase, nursing education in Canada will face a severe human resources crisis within the next decade, and certain schools of nursing will not have the critical mass of faculty to deliver their undergraduate and graduate programs. Various factors contributing to the shortage of faculty are highlighted, including the aging of the professoriate; superior salaries and benefits available in non-academic settings; and excessive academic workloads. Resolving and effectively managing the nursing faculty crisis needs to be regarded as a national health-care priority. The authors provide recommendations for addressing the problem.     

The Department of Veterans Affairs Nursing Academy (VANA): forging strategic alliances with schools of nursing to address nursing's workforce needs

In 2007, the Department of Veterans Affairs (VA) established the VA Nursing Academy (VANA), a 5-year, $60-million pilot program funding 15 partnerships between schools of nursing and local VA health care facilities nationwide, to expand nursing faculty, enhance clinical faculty development, increase nursing student enrollment, and promote educational innovations. VA is an ideal setting for educating nursing students owing to a well-educated registered nurse staff, an array of traditional and nontraditional settings, a state-of-the-art computerized electronic health record system, and a unique patient population. Challenges related to the complex nature of VANA partnerships, conceptualized as strategic alliances created between disparate subunits, each embedded in a larger organization, require careful governance to ensure smooth implementation. To ensure the program’s aims are met, a 6-year national evaluation has been funded to help identify which strategies best achieve VANA’s goals. The speed of economic recovery and the resulting changes in the nursing workforce are important determinants of VANA’s future.     

The Importance and Impact of Nurse Leader Engagement With State Nursing Workforce Centers: Lessons From the COVID-19 Pandemic

The COVID-19 pandemic caused unparalleled morbidity and mortality across the globe. Health care agencies, public health departments, and academic institutions experienced widespread disruption to usual operations. These events had an adverse impact on the nursing workforce. Nurse leaders in California rallied to identify and remediate the effects of COVID-19 on the nursing workforce. This article describes the strategy and interventions. Nurse leaders should invest resources in state workforce centers to ensure the health and supply of a strong nursing workforce.     

The rural pipeline: building a strong nursing workforce through academic and service partnerships

Nurse recruitment and the retention of a high-quality workforce are challenging issues facing rural hospitals and health centers. The Bassett Healthcare Network has met these challenges by building a supportive framework to develop and support nurses at every level of their professional careers. The organization has partnered with local colleges to help staff nurses further their education. These and other partnership endeavors, such as the organization's clinical ladder and collaborative continuing nursing education opportunities, are helping Bassett sustain and grow the nursing workforce across 8 counties in rural upstate New York and develop stronger ties with academic partners.     

From Evidence-Based Practice to Knowledge Translation: What Is the Difference? What Are the Roles of Nurse Leaders?

ObjectivesNurses, as the largest healthcare workforce, are well-positioned to apply knowledge translation. The role of nursing leadership in facilitating evidence-based practice has been extensively discussed in the literature, but this is not the case for knowledge translation. The objective of this study was to examine the potential role of nurse leaders in applying knowledge translation across health settings.Data SourcesWe reviewed the existing literature for evidence-based practice as best practice in clinical care; examined how a complex systems approach to knowledge translation may extend beyond evidence-based practice, and considered nursing leadership approaches including transformational leadership.ConclusionIn this discursive article, we discuss the differences between evidence-based practice and knowledge translation, highlight the promise of transformational leadership in facilitating knowledge translation through a complex systems lens, and argue for the importance of nurse leaders in facilitating and supporting complex knowledge translation across healthcare settings.Implications for Nursing PracticeAlthough future research is needed to test our ideas, we argue that the advanced conceptual understanding generated in this article should inform a roadmap toward a future in which nurse leaders initiate, participate and advocate for complex knowledge translation across healthcare settings.     

Leadership by collaboration: Nursing's bold new vision for academic-practice partnerships

In 2016 the American Association of Colleges of Nursing issued a report, Advancing Healthcare Transformation: A New Era for Academic Nursing that included recommendations for more fully integrating nursing education, research, and practice. The report calls for a paradigm shift in how nursing leaders in academia and practice work together and with other leaders in higher education and clinical practice. Only by doing so can we realize the full benefits of academic nursing in this new era in which integration and collaboration are essential to success. In this paper we: 1) examine how academic nursing can contribute to healthcare innovation across environments; 2) explore leadership skills for deans of nursing to advance the goals of academic nursing in collaboration with clinical nursing partners, other health professions and clinical service leaders, academic administrators, and community members; and, 3) consider how governance structures and policy initiatives can advance this work.     

Policy analysis and advocacy in nursing education: the Nursing Education Council of British Columbia framework

Academic nursing leaders play a crucial role in the policy context for nursing education. Effectiveness in this role requires that they work together in presenting nursing education issues from a position of strength, informed by a critical analysis of policy pertaining to the delivery of quality nursing education and scholarship. We describe a collective process of dialog and critical analysis whereby nurse leaders in one Canadian province addressed pressing policy issues facing governments, nursing programs, faculty, and students. Consensus among academic nurse leaders, formalized through the development of a policy action framework, has enabled us to take a stand, at times highly contested, in the politicized arena of the nursing shortage. We present the components of a policy action framework for nursing education and share examples of how we have used a critical approach to analyze and frame policy issues in nursing education for inclusion on policy agendas. We believe our work has influenced provincial and national thinking about policy in nursing education is the foundation of our conclusion that political presence and shared strategy among academic nursing leaders is undeniably critical in the global context of nursing today.     

Nursing Leaders as Visionaries and Enablers of Action

ObjectivesThe engagement of nursing leaders is critical for the future of the cancer nursing profession, quality cancer care, and the overall health care system. The field of cancer care is facing enormous challenges, requiring strong nursing leadership. Cancer nursing leadership is needed to overcome the challenges caused by workforce shortages, restricted resources, historic and ongoing under-recognition of nursing, unsafe working conditions, and unequal access to education. The aim of this article is to contribute to the discussion about how cancer nursing leaders can act as visionaries and support transformation of cancer nursing for the future.Data SourcesAuthor experience, journal articles and organizational position papers were used.ConclusionTo improve the state of cancer nursing and the working conditions of the cancer nursing workforce, nursing leadership practices need to be embraced on all governance levels in clinical practice and academia. When effective and high-quality nursing leadership is enacted, positive outcomes for people affected by cancer, nursing, and health care systems can be achieved. Cancer nursing leadership needs to be supported through nursing scholarship, influencing national and global policies and strategies and by active involvement in national and international health care management.Implications for Nursing PracticeNursing leadership and governance is critical to strengthening the cancer nursing workforce. Strong nursing leadership is required to realize the vision for transforming the health care systems and cancer care. Therefore, collaboration among multidisciplinary leadership, health care organizations, academic institutions, professional organizations, and policy-making structures is warranted.     

Becoming a nurse faculty leader: Taking risks by doing the right thing

Risk taking is a key aspect of academic leadership essential to meeting the challenges and opportunities in higher education. What are the practices of risk taking in nurse faculty leaders? This interpretive phenomenological study examines the experience and meaning of risk taking among nurse leaders. The theme of doing the right thing is brought forth through in-depth hermeneutic analysis of 14 individual interviews and two focus group narratives. The practice of doing the right thing is propelled and captured by leaders through a sense professional responsibility, visioning the future, and being true to self and follow one's core values. This study develops an evidence base for incorporating ways of doing the right thing in leadership development activities at a time when there is tremendous need for highly effective leaders in academic settings. Examining the practices of doing the right thing as a part of leadership development lays a foundation for building the next generation of nursing leaders prepared to navigate the ever-changing and complex academic and health care environments.     

Variation in academic preparation and progression of nurses across the continuum of care

BackgroundChanging health care needs are driving new models of care that emphasize care coordination, health promotion, and disease management by registered nurses (RNs). A skill-mix favoring professional (baccalaureate or above) over technical (less than baccalaureate) education is promoted by national initiatives.PurposeTo examine the academic preparation and progression of general practice RNs in practice settings across the care continuum.MethodSecondary analyses of data from the Texas Board of Nurses RN Licensure databases in 2008 and 2014.FindingsOverall the professional skill-mix for general practice RNs improved from 47.1% to 50.2%. Disparities were identified in home health (31.6%), long-term care (27.8%) and nonmetropolitan areas (31.7%). Role change was the strongest correlate of academic progression.DiscussionNon-hospital and rural practice settings may be vulnerable to the effects of an undereducated RN workforce. More effective reimbursement policies and employer incentives are needed to drive academic progression and address disparities across practice settings.