JONA Volume 44, Number 7/8, pp 378-380 Copyright B 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Spotlight on Education
Transforming the Academia-Practice Partnership Through an Innovative Role Design Debra Jeffs, PhD, RN Lori Brown, MSN, DHA, RN, CENP, FACHE, CPHQ The director of academic nursing education was created to strengthen the relationship between academic nursing education and clinical practice with goals of advancing nurses’ academic education and preparing the future pediatric nursing workforce for 1 organization.
a bachelor’s or higher degree have reported lower patient mortality and failure-to-rescue rates.2 This evidence led the Institute of Medicine (IOM) to recommend that 80% of RNs should hold a baccalaureate or graduate nursing degree by 2020.2 Organizations seeking ANCC Magnet Recognition must move toward this goal.3 Advanced education supports the development of competencies to improve quality, safety, and efficiency of care delivery including coordinating care across the continuum; engaging and leading quality improvement initiatives; using informatics and technology to improve care; understanding healthcare finances; applying systems thinking; critically appraising evidence; and implementing evidence-based practice.2,4-6 Raising educational levels of nurses has resulted in a more highly educated nursing workforce while challenging nursing education programs to offer flexible, high-quality degree options, and seamless transitions between programs for nurses returning to school.2,4 A
Transformative nursing leadership requires courage, creativity, and risk taking to envision the future.1 Reexamining the current nursing workforce in response to growing evidence linking improved patient outcomes and nurses’ higher educational preparation is a key strategy for nurse executives (NEs).2 Hospitals with higher proportions of nurses with
Author Affiliations: Director of Academic Nursing Education (Dr Jeffs), Arkansas Children’s Hospital, Little Rock; and Adjunct Assistant Professor, College of Nursing, University of Arkansas for Medical Sciences, Little Rock; Chief Nursing Executive (Dr Brown), Sunrise Hospital and Medical Center and Sunrise Children’s Hospital, Las Vegas, Nevada; and Former Chief Nursing Officer and Senior Vice President for Patient Care Services, Arkansas Children’s Hospital, Little Rock. No funding was received for this study. The authors declare no conflicts of interest. Correspondence: Dr Jeffs, Arkansas Children’s Hospital, 1 Children’s Way, Little Rock, AR 72202 ([email protected]). DOI: 10.1097/NNA.0000000000000086
378
Role Creation Guided by the NEs’ vision, nursing leaders of a children’s hospital in the mid-south United States created a
strategic plan for nursing inclusive of goals around academic education levels. In early 2010, the then director of the nursing education department transitioned to the new role of director of academic nursing education to fulfill an identified initiative. The NE envisioned attainment of nurses’ achievement of advanced nursing education, improved connections in the community including relationships with schools of nursing, and building a welleducated nursing workforce for the future as goals for this role. In addition, the enhancement of the clinical experience for students to better prepare them for the hospital nursing practice role was another objective. The director, with a 25-year career in academic nursing education, brought extensive teaching and curricula experience at the diploma, associate degree, baccalaureate (BSN), and master’s degree levels in both traditional and online distance education to the role. This leader was identified as a natural fit for the new position designed to mesh the academic and practice environments together, creating a connection between academic education and practice for student nurses, new nurses, and nurses returning to school for an advanced degree.
JONA Vol. 44, No. 7/8 July/August 2014
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Spotlight on Education Role Implementation Leadership As a member of the nursing leadership team, the director advises the team including the NE regarding progress toward educational goal achievement. Serving as a leader in the shared decision-making councilor infrastructure, the director guided discussions around achieving the goal for RN advanced education. Consideration included a review of the organization’s nurse vacancy rate and acknowledgement of the limited number of prelicensure BSN graduates in the state. The council recommendations included strategic hiring practices targeting BSN-prepared nurses as well as internal academic education promotion to achieve a higher percentage of BSNs in the current workforce. In support of these goals, the director championed the recently created professional development career map process. This innovative model introduced nurses to planning for career advancement along the clinical ladder or when preparing for another role, such as educator or manager. Career mapping is a collaborative activity where the nurse, nurse leader, and director work to identify the necessary steps to achieve success including returning to school for an advanced degree. The director authored informational literature emphasizing the importance of continuing academic nursing education, including listings of available educational programs and financial aid resources. As a leader on the state action coalition in support of the IOM goal, the director is a resource regarding the recommendations on education for coalition employees as well as others. The director serves on the organization’s review team for scope of practice,
ensuring nursing practice alignment with state regulations, national trends, and best practice evidence. The director extends leadership for academic education to other nonnursing departments by serving as a consultant for standardizing student practicum experiences across the organization including development of student orientation to promote consistency for all students entering the organization. Collaboration with the volunteer services department links high school and college students with clinicians through the shadowing program. Enhancing Student Education With education embedded in its mission, the organization had a long-standing commitment to provide pediatric clinical learning experiences for student nurses. The director became responsible for all matters concerning schools of nursing and particularly with students to engage and attract them to the acute care hospital environment. The director serves as support consultant and advisor to nurses, nurse leaders, and faculty regarding student clinical experiences. Hospital nurses are integral to the education of student nurses at all degree levels serving as preceptors, instructors, and faculty. As a key contact person, the director quickly became an essential resource to promote understanding of the student experience and guide nurses in advancing their own professional career goals. As an internal leader, the director has been positioned to create a connection with the schools of nursing, identifying qualified nurses in the hospital to serve as preceptors or faculty. To further connect to the external professional community, the director holds an annual meeting with
JONA Vol. 44, No. 7/8 July/August 2014
schools of nursing inviting all faculty, coordinators, chairs, and deans to attend. The director chairs the meeting and provides an update about relevant organizational information that affects schools of nursing. The meeting offers nurse leaders and school representatives an opportunity for networking. In addition, the director serves on several schools of nursing advisory boards to share workplace trends in the practice environment and offer curricular recommendations. The director co-led development of a pediatric clinical nurse specialist curriculum designed to promote this role for nurses. RN Academic Education The director provides hospital nurses with ongoing consultation about returning to school for advanced nursing education by exploring career goals, identifying degree program fit with current life circumstances, and connecting academic projects with work-related goals. The director coordinates biannual on-site education fairs with school of nursing representatives offering information about education programs and is present to facilitate decision making about returning to school. Professional advancement of nurses includes educating nurses for leadership positions in practice, education, and research. Facilitating mentored practicum placements ranging from baccalaureate level leadership/management experiences to advanced practice clinical experiences as well as direct tutoring, mentoring, and precepting of nurses who are in school is integral to the role. The PhD-prepared director is a funded investigator on multiple studies serving as a role model to educate and mentor nurses about research and evidence-based practice.
379
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Spotlight on Education Academic Nursing Education Outcomes Table 1 presents a summary of outcomes achieved since implementing the director position. No institutional review board submission was requested because of the focus on organizational improvement.
Implications for Nurse Leaders Alignment of organizational nursing goals with IOM recommendations for the future of nursing2 presents challenges and opportunities for nurse leaders. The NE’s vision in this organization of enhancing the connection between academic education and practice led to specific approaches to achieve the organization’s goals of all nurse leaders holding a minimum of a BSN, increasing the percentage of nurses with a BSN, and preparing the future pediatric nursing work-
force. As an initial step, securing support from the organization’s board and executive leaders was essential. The director serves as a conduit to promote organizational goals around aligning academic education and practice. As a member of the nursing leadership team, the director assists in achieving goals established through creative visioning and strategic thinking required of transformative nursing leaders to influence nursing workforce changes and practice improvements. Whether our 10% increase in the number of nurses with advanced nursing education has been associated with improvements in quality is uncertain, but a longitudinal study did report that increasing education levels does make a difference, and experience is not a substitute for higher education in improving clinical outcomes.7 Creation of the
Table 1. Impact of Academic Nursing Education Director Position & Affiliation agreements with 40 schools of nursing from all educational levels & Collaboration with nursing schools to promote advanced degrees & Increased practicum placements for APRN students & 1,425 Students educated in 2012-2013 increased from 1,080 in 2010-2011 & 46 Hospital nurses serve as clinical instructors and student preceptors; positive feedback from students, nurses, and school leaders & More than 400 nurses advised about advanced nursing degree options & More than 120 nurses graduated from advanced nursing degree programs & 20% Of nurses currently pursuing an advanced nursing degree & 59% Of all RNs (91,400) hold a BSN or higher nursing degree increased from a static 45% & 100% Of nurse directors hold a minimum of a BSN increased from 60% in 2010, achieved 2 y ahead of goal; many pursuing graduate education & Frontline managers on track to achieve BSN by 2015 & 100% Of nurse educators hold a minimum of a BSN & All NEs hold a minimum of a BSN; all hold graduate degrees & Improved hiring decisions directed toward nurses’ academic education & Improved academic education policy setting and communication
380
role of director of academic nursing education is a unique strategy to enhance the academic-practice partnership to meet goals around strengthening the nursing workforce. Advancing education levels among the workforce in this pediatric organization supported the goal of achieving nursing excellence through an educated workforce. REFERENCES 1. Drenkard K. The transformative power of personal and organizational leadership. Nurs Adm Q. 2012;36(2):147-154. 2. Institute of Medicine. Future of Nursing: Leading Change, Advancing Health. Washington, DC: The National Academies Press; 2011. http://www.nap.edu/download .php?record_id=12956. A c c e s s e d September 6, 2013. 3. American Nurses Credentialing Center. Magnet Recognition ProgramA FAQ: Data and Expected Outcomes. Silver Spring, MD: American Nurses Credentialing Center; 2013. http://www.nursecredentialing .org/DEO-FAQ#B2. Accessed September 6, 2013. 4. Institute of Medicine. A Summary of the February 2010 Forum on the Future of Nursing: Education. Washington, DC: The National Academies Press; 2010. http://www.nap.edu/download.php? record_id=12894. Accessed September 6, 2013. 5. Benner P, Sutphen M, Leonard V, Day L. Educating Nurses: A Call for Radical Transformation. San Francisco, CA: JosseyBass; 2010. 6. Robert Wood Johnson Foundation. George Washington University School of Nursing. Why academic progression matters. Chart Nurs Future. 2013;21:2. 7. Kutney-Lee A, Sloane DM, Aiken LH. An increase in the number of nurses with baccalaureate degrees is linked to lower rates of postsurgical mortality. Health Aff. 2013;32(3):579-586.
JONA Vol. 44, No. 7/8 July/August 2014
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Spotlight on Education
Transforming the Academia-Practice Partnership Through an Innovative Role Design Debra Jeffs, PhD, RN Lori Brown, MSN, DHA, RN, CENP, FACHE, CPHQ The director of academic nursing education was created to strengthen the relationship between academic nursing education and clinical practice with goals of advancing nurses’ academic education and preparing the future pediatric nursing workforce for 1 organization.
a bachelor’s or higher degree have reported lower patient mortality and failure-to-rescue rates.2 This evidence led the Institute of Medicine (IOM) to recommend that 80% of RNs should hold a baccalaureate or graduate nursing degree by 2020.2 Organizations seeking ANCC Magnet Recognition must move toward this goal.3 Advanced education supports the development of competencies to improve quality, safety, and efficiency of care delivery including coordinating care across the continuum; engaging and leading quality improvement initiatives; using informatics and technology to improve care; understanding healthcare finances; applying systems thinking; critically appraising evidence; and implementing evidence-based practice.2,4-6 Raising educational levels of nurses has resulted in a more highly educated nursing workforce while challenging nursing education programs to offer flexible, high-quality degree options, and seamless transitions between programs for nurses returning to school.2,4 A
Transformative nursing leadership requires courage, creativity, and risk taking to envision the future.1 Reexamining the current nursing workforce in response to growing evidence linking improved patient outcomes and nurses’ higher educational preparation is a key strategy for nurse executives (NEs).2 Hospitals with higher proportions of nurses with
Author Affiliations: Director of Academic Nursing Education (Dr Jeffs), Arkansas Children’s Hospital, Little Rock; and Adjunct Assistant Professor, College of Nursing, University of Arkansas for Medical Sciences, Little Rock; Chief Nursing Executive (Dr Brown), Sunrise Hospital and Medical Center and Sunrise Children’s Hospital, Las Vegas, Nevada; and Former Chief Nursing Officer and Senior Vice President for Patient Care Services, Arkansas Children’s Hospital, Little Rock. No funding was received for this study. The authors declare no conflicts of interest. Correspondence: Dr Jeffs, Arkansas Children’s Hospital, 1 Children’s Way, Little Rock, AR 72202 ([email protected]). DOI: 10.1097/NNA.0000000000000086
378
Role Creation Guided by the NEs’ vision, nursing leaders of a children’s hospital in the mid-south United States created a
strategic plan for nursing inclusive of goals around academic education levels. In early 2010, the then director of the nursing education department transitioned to the new role of director of academic nursing education to fulfill an identified initiative. The NE envisioned attainment of nurses’ achievement of advanced nursing education, improved connections in the community including relationships with schools of nursing, and building a welleducated nursing workforce for the future as goals for this role. In addition, the enhancement of the clinical experience for students to better prepare them for the hospital nursing practice role was another objective. The director, with a 25-year career in academic nursing education, brought extensive teaching and curricula experience at the diploma, associate degree, baccalaureate (BSN), and master’s degree levels in both traditional and online distance education to the role. This leader was identified as a natural fit for the new position designed to mesh the academic and practice environments together, creating a connection between academic education and practice for student nurses, new nurses, and nurses returning to school for an advanced degree.
JONA Vol. 44, No. 7/8 July/August 2014
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Spotlight on Education Role Implementation Leadership As a member of the nursing leadership team, the director advises the team including the NE regarding progress toward educational goal achievement. Serving as a leader in the shared decision-making councilor infrastructure, the director guided discussions around achieving the goal for RN advanced education. Consideration included a review of the organization’s nurse vacancy rate and acknowledgement of the limited number of prelicensure BSN graduates in the state. The council recommendations included strategic hiring practices targeting BSN-prepared nurses as well as internal academic education promotion to achieve a higher percentage of BSNs in the current workforce. In support of these goals, the director championed the recently created professional development career map process. This innovative model introduced nurses to planning for career advancement along the clinical ladder or when preparing for another role, such as educator or manager. Career mapping is a collaborative activity where the nurse, nurse leader, and director work to identify the necessary steps to achieve success including returning to school for an advanced degree. The director authored informational literature emphasizing the importance of continuing academic nursing education, including listings of available educational programs and financial aid resources. As a leader on the state action coalition in support of the IOM goal, the director is a resource regarding the recommendations on education for coalition employees as well as others. The director serves on the organization’s review team for scope of practice,
ensuring nursing practice alignment with state regulations, national trends, and best practice evidence. The director extends leadership for academic education to other nonnursing departments by serving as a consultant for standardizing student practicum experiences across the organization including development of student orientation to promote consistency for all students entering the organization. Collaboration with the volunteer services department links high school and college students with clinicians through the shadowing program. Enhancing Student Education With education embedded in its mission, the organization had a long-standing commitment to provide pediatric clinical learning experiences for student nurses. The director became responsible for all matters concerning schools of nursing and particularly with students to engage and attract them to the acute care hospital environment. The director serves as support consultant and advisor to nurses, nurse leaders, and faculty regarding student clinical experiences. Hospital nurses are integral to the education of student nurses at all degree levels serving as preceptors, instructors, and faculty. As a key contact person, the director quickly became an essential resource to promote understanding of the student experience and guide nurses in advancing their own professional career goals. As an internal leader, the director has been positioned to create a connection with the schools of nursing, identifying qualified nurses in the hospital to serve as preceptors or faculty. To further connect to the external professional community, the director holds an annual meeting with
JONA Vol. 44, No. 7/8 July/August 2014
schools of nursing inviting all faculty, coordinators, chairs, and deans to attend. The director chairs the meeting and provides an update about relevant organizational information that affects schools of nursing. The meeting offers nurse leaders and school representatives an opportunity for networking. In addition, the director serves on several schools of nursing advisory boards to share workplace trends in the practice environment and offer curricular recommendations. The director co-led development of a pediatric clinical nurse specialist curriculum designed to promote this role for nurses. RN Academic Education The director provides hospital nurses with ongoing consultation about returning to school for advanced nursing education by exploring career goals, identifying degree program fit with current life circumstances, and connecting academic projects with work-related goals. The director coordinates biannual on-site education fairs with school of nursing representatives offering information about education programs and is present to facilitate decision making about returning to school. Professional advancement of nurses includes educating nurses for leadership positions in practice, education, and research. Facilitating mentored practicum placements ranging from baccalaureate level leadership/management experiences to advanced practice clinical experiences as well as direct tutoring, mentoring, and precepting of nurses who are in school is integral to the role. The PhD-prepared director is a funded investigator on multiple studies serving as a role model to educate and mentor nurses about research and evidence-based practice.
379
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Spotlight on Education Academic Nursing Education Outcomes Table 1 presents a summary of outcomes achieved since implementing the director position. No institutional review board submission was requested because of the focus on organizational improvement.
Implications for Nurse Leaders Alignment of organizational nursing goals with IOM recommendations for the future of nursing2 presents challenges and opportunities for nurse leaders. The NE’s vision in this organization of enhancing the connection between academic education and practice led to specific approaches to achieve the organization’s goals of all nurse leaders holding a minimum of a BSN, increasing the percentage of nurses with a BSN, and preparing the future pediatric nursing work-
force. As an initial step, securing support from the organization’s board and executive leaders was essential. The director serves as a conduit to promote organizational goals around aligning academic education and practice. As a member of the nursing leadership team, the director assists in achieving goals established through creative visioning and strategic thinking required of transformative nursing leaders to influence nursing workforce changes and practice improvements. Whether our 10% increase in the number of nurses with advanced nursing education has been associated with improvements in quality is uncertain, but a longitudinal study did report that increasing education levels does make a difference, and experience is not a substitute for higher education in improving clinical outcomes.7 Creation of the
Table 1. Impact of Academic Nursing Education Director Position & Affiliation agreements with 40 schools of nursing from all educational levels & Collaboration with nursing schools to promote advanced degrees & Increased practicum placements for APRN students & 1,425 Students educated in 2012-2013 increased from 1,080 in 2010-2011 & 46 Hospital nurses serve as clinical instructors and student preceptors; positive feedback from students, nurses, and school leaders & More than 400 nurses advised about advanced nursing degree options & More than 120 nurses graduated from advanced nursing degree programs & 20% Of nurses currently pursuing an advanced nursing degree & 59% Of all RNs (91,400) hold a BSN or higher nursing degree increased from a static 45% & 100% Of nurse directors hold a minimum of a BSN increased from 60% in 2010, achieved 2 y ahead of goal; many pursuing graduate education & Frontline managers on track to achieve BSN by 2015 & 100% Of nurse educators hold a minimum of a BSN & All NEs hold a minimum of a BSN; all hold graduate degrees & Improved hiring decisions directed toward nurses’ academic education & Improved academic education policy setting and communication
380
role of director of academic nursing education is a unique strategy to enhance the academic-practice partnership to meet goals around strengthening the nursing workforce. Advancing education levels among the workforce in this pediatric organization supported the goal of achieving nursing excellence through an educated workforce. REFERENCES 1. Drenkard K. The transformative power of personal and organizational leadership. Nurs Adm Q. 2012;36(2):147-154. 2. Institute of Medicine. Future of Nursing: Leading Change, Advancing Health. Washington, DC: The National Academies Press; 2011. http://www.nap.edu/download .php?record_id=12956. A c c e s s e d September 6, 2013. 3. American Nurses Credentialing Center. Magnet Recognition ProgramA FAQ: Data and Expected Outcomes. Silver Spring, MD: American Nurses Credentialing Center; 2013. http://www.nursecredentialing .org/DEO-FAQ#B2. Accessed September 6, 2013. 4. Institute of Medicine. A Summary of the February 2010 Forum on the Future of Nursing: Education. Washington, DC: The National Academies Press; 2010. http://www.nap.edu/download.php? record_id=12894. Accessed September 6, 2013. 5. Benner P, Sutphen M, Leonard V, Day L. Educating Nurses: A Call for Radical Transformation. San Francisco, CA: JosseyBass; 2010. 6. Robert Wood Johnson Foundation. George Washington University School of Nursing. Why academic progression matters. Chart Nurs Future. 2013;21:2. 7. Kutney-Lee A, Sloane DM, Aiken LH. An increase in the number of nurses with baccalaureate degrees is linked to lower rates of postsurgical mortality. Health Aff. 2013;32(3):579-586.
JONA Vol. 44, No. 7/8 July/August 2014
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
