Category Archives: Education and training

Mar 25 2014
Comments

Sharing Nursing’s Knowledge: The March 2014 Issue

Have you signed up to receive Sharing Nursing’s Knowledge? The monthly Robert Wood Johnson Foundation (RWJF) e-newsletter will keep you up to date on the work of the Foundation’s nursing programs, and the latest news, research, and trends relating to academic progression, leadership, and other essential nursing issues. Following are some of the stories in the March issue.

Nurses Need Residency Programs Too, Experts Say
Health care experts, including the Institute of Medicine in its report on the future of nursing, tout nurse residency programs as a solution to high turnover among new graduate nurses. Now, more hospitals are finding that these programs reduce turnover, improve quality, and save money. Success stories include Seton Healthcare Family in Austin, Texas, which launched a residency program to help recent nursing school graduates transition into clinical practice. Now, three out of four new graduate nurses make it to the two-year point, and five or six new nurse graduates apply for each vacant position.

Iowa Nurses Build Affordable, Online Nurse Residency Program
Some smaller health care facilities, especially in rural areas, cannot afford to launch nurse residency programs to help new nurses transition into clinical practice. A nursing task force in Iowa has developed an innovative solution: an online nurse residency program that all health care facilities in the state—and potentially across the country—can use for a modest fee. The task force was organized by the Iowa Action Coalition and supported by an RWJF State Implementation Program grant.

Read more

Mar 14 2014
Comments

‘Teamwork Works’: Lessons Learned From the Front Line of Team-Based Care

As the patient-centered medical home (PCMH) has emerged as a model for providing effective team-based care that can help offset the impending primary care provider shortage, so, too, is there a growing need for educational strategies that promote interprofessional collaboration. A short report published online by the Journal of Interprofessional Care describes the strategies in place at the VA Connecticut Healthcare System Center of Excellence in Primary Care Education (CoEPCE) and indicates promising results in just one year: doubled productivity in patient care delivered by faculty providers, and a marked increase in same-day clinic access for patients receiving care from an interprofessional team.

The Connecticut CoEPCE, like four other program sites funded through the U.S. Department of Veterans Affairs Office of Academic Affiliations, builds on the VA’s system-wide PCMH model, known as Patient Aligned Care Teams (PACT). It seeks to develop exportable models of interprofessional education and patient care, according to the report, “Moving From Silos to Teamwork: Integration of Interprofessional Trainees Into a Medical Home Model.” The CoEPCE sites share four core curricular domains—shared decision-making, sustained relationships, interprofessional collaboration, and performance improvement—and the Connecticut center groups together physician, nurse practitioner (NP), pharmacy, and health psychology trainees.

The trainees divide their time evenly between interactive educational sessions and caring for patients, guided by faculty who provide supervision, mentorship, and collaborative shared care. Additionally, the Connecticut center incorporates a one-year post-master’s adult NP interprofessional clinical fellowship, to further enhance clinical proficiency and teamwork experience for NPs.

Read more

Feb 11 2014
Comments

Taking a Hint from Home Hospice Care to Help Those Who Die in Hospitals

Adopting best practices from home-based hospice care in the inpatient environment can reduce suffering at the end of life, according to a study published in the Journal of General Internal Medicine.  Researchers at the Birmingham Veterans Affairs Medical Center and the University of Alabama at Birmingham said the study is the first to show that palliative care techniques usually used in home settings can have an impact on those who die in hospitals.

The Best Practices for End-of-Life Care for Our Nation’s Veterans (BEACON) trial was conducted at six Veterans Affairs Medical Centers from 2005 to 2011 and involved training more than 1,620 staff members in aspects of care for more than 6,000 dying patients. Although focused on veterans, the study can have a wider impact, researchers said, because most Americans will die in the inpatient setting of a hospital or nursing home.

“We only die once, and therefore there is only one opportunity to provide excellent care to a patient in the last days of life,” wrote lead author F. Amos Bailey, MD, director of the Safe Harbor Palliative Care Program at the Birmingham Veterans Affairs Medical Center, professor in the Division of Gerontology, Geriatrics and Palliative Care at the University of Alabama at Birmingham School of Medicine, and a 2000 Robert Wood Johnson Foundation Community Health Leader. “The keys to excellent end-of-life care are recognizing the imminently dying patient, communicating the prognosis, identifying goals of care, and anticipating and palliating symptoms. Since it is not possible to predict with certainty which symptoms will arise, it is prudent to have a flexible plan ready.”

Read more

Jan 21 2014
Comments

Interprofessional Education: Not Just for the Fun of It

Brenda Zierler, PhD, RN, FAAN, is a professor of behavioral nursing and health systems at the University of Washington in Seattle, where she focuses on interprofessional education in the health professions. She is an alumna of the Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellows program (2008-2011). This post is part of the “Health Care in 2014” series, in which health leaders, as well as Robert Wood Johnson Foundation scholars, grantees, and alumni, share their New Year’s resolutions for our health care system and their priorities for action this year.

file

Over the last several years, health professional students at the University of Washington (UW) in Seattle have had numerous opportunities to participate in interprofessional education (IPE) events using a variety of pedagogical approaches, experiences, and technologies such as unfolding web-based cases, team-building exercises, simulated scenarios, mock codes, joint quality improvement placements, shadowing health professionals, and service learning in the community.

These activities are highly rated, and students typically provide positive testimonials about the importance of working together early in their training. Although the feedback provided by the students is overwhelmingly positive, I was concerned that the students were not fully understanding the rationale for these numerous IPE activities, which are logistically challenging to develop, implement, and evaluate.

I was recently invited to give a lecture to describe local and national IPE initiatives to pre-licensure students in a UW leadership class. These students had participated in two IPE events during one academic quarter. While standing outside of the classroom waiting for the first guest speaker to finish his PowerPoint lecture, I decided to abandon the lecture and instead to facilitate a discussion on the rationale for the IPE events. 

Read more

Jan 17 2014
Comments

Accelerating Support for Nursing Education

Jane Kirschling, PhD, RN, FAAN, is president of the American Association of Colleges of Nursing and an alumna of the Robert Wood Johnson Foundation Executive Nurse Fellows program. This post is part of the “Health Care in 2014” series, in which health leaders, as well as Robert Wood Johnson Foundation scholars, grantees, and alumni, share their New Year’s resolutions for our health care system and their priorities for action this year.

file

2014 marks the 10th anniversary of the landmark study conducted by Linda Aiken, PhD, FAAN, FRCN, RN, and colleagues, which showed a strong connection between nursing education and patient outcomes. Published in the September 2004 issue of the Journal of the American Medical Association (JAMA), the study’s researchers found that patients experienced significantly lower mortality and failure to rescue rates in hospitals with higher proportions of baccalaureate-prepared nurses. In her analysis, Dr. Aiken stated that the study’s results “suggest that employers’ efforts to recruit and retain baccalaureate-prepared nurses in bedside care and their investments in further education for nurses may lead to substantial improvements in the quality of care.”

Read more

Jan 15 2014
Comments

Nurses: Leading with Purpose, Power, and Passion to Advance the Nation’s Health

A High Priority for Action in 2014

Marsha Howell Adams, PhD, RN, CNE, ANEF, is president of the National League for Nursing (NLN), and senior associate dean of academic programs and professor at The University of Alabama Capstone College of Nursing.  This post is part of the “Health Care in 2014” series, in which health leaders, as well as Robert Wood Johnson Foundation scholars, grantees, and alumni, share their New Year’s resolutions for our health care system and their priorities for action this year.

file

This past December, I was lucky to attend a holiday reception at the White House with Judith Halstead, PhD, RN, FAAN, ANEF, my immediate predecessor as president of the NLN. It’s one of the nice benefits of being president.

I have experienced the White House via public tours many times throughout the years, but this visit was very different. We were able to explore rooms that those on White House tours can only glimpse from the hallways. We could study the art on the walls and absorb a sense of the purpose, power, and passion of past and present leaders. The prospect of meeting the president and first lady created such an excitement in me that it almost took my breath away. No matter one’s political point of view, meeting our nation’s president, especially in the White House, is truly an honor and a privilege.

Read more

Jan 2 2014
Comments

Cost-Conscious Care Training: A Missing Ingredient in Many Residency Programs

Given near-universal concern over rising health care costs, are new physicians being taught to keep costs in check?

Not enough of them, according to a research letter published in JAMA Internal Medicine in December. Lead author Mitesh Patel, MD, MBA, a Robert Wood Johnson Foundation (RWJF) Clinical Scholar at the University of Pennsylvania, and his research team analyzed survey responses from nearly 300 U.S. internal medicine residency programs. They found that fewer than 15 percent have curricula designed to teach residents to be more cost-conscious.

“Evidence shows that physicians who recently completed residency training practice medicine at a higher cost than more experienced physicians,” Patel and his team wrote. Among 295 programs that responded to a questionnaire on cost-conscious care in a 2012 survey from the Association of Program Directors in Internal Medicine, 14.9 percent indicated that they had a formal curriculum in cost-conscious care; another 49.8 percent responded that they did not, but were working on it.

Read more

Dec 19 2013
Comments

New Online Program in West Virginia Will Expand Access to BSN Education

Efforts to increase the percentage of baccalaureate-educated nurses in West Virginia are getting a boost from a new online RN-to-BSN program at the University of Charleston (UC) in the state capital. The program, which will begin in the spring, will allow registered nurses (RNs) to complete requirements for a bachelor of science in nursing (BSN) degree in as little as 18 months.

The university’s president, Ed Welch, PhD, said in a news release that the program “answers an immediate need of West Virginia’s health care facilities. By completing their bachelor’s degree at UC in just 18 months, and continuing to work full time, nurses are able to advance their careers and better serve patients in the field.”

Robert Wood Johnson Foundation Executive Nurse Fellows program alumnus Duane Napier, MSN, RN-BC, formerly executive director of the West Virginia Center for Nursing, is the UC RN-BSN program coordinator. “We’ve had a great response since announcing the program,” Napier said in an interview. “It's the state's first online program that doesn't require any campus sessions, so it's truly designed for the working nurse.”

Read more

Dec 17 2013
Comments

Safety-Net Settings Study: If You Train Docs There, They’ll Likely Return

Newly minted physicians who train in underserved health facilities are much more likely to continue practicing in such facilities after completing their residency training, according to research by the Robert Graham Center for Policy Studies in Family Medicine and Primary Care, an independent research unit of the American Academy of Family Physicians (AAFP).

The study, “Do Residents Who Train in Safety Net Settings Return for Practice?,” found that up to half of medical residents who trained in rural health clinics, critical access hospitals, and federally qualified health centers—which serve most of the nation's uninsured and underinsured patients—returned to practice in those settings. The study is published in the December issue of Academic Medicine.

“Overall, between one-third and one-half of the residents we identified in any of these settings during training were also identified as practicing in these same settings after training,” writes Robert Phillips, MD, MSPH, and his co-authors.

Read more

Dec 11 2013
Comments

Recent Research About Nursing, December 2013

This is part of the December 2013 issue of Sharing Nursing’s Knowledge.

Americans Favor Increased Access to Nurse Practitioners

A new telephone survey commissioned by the American Association of Nurse Practitioners (AANP) shows strong support for increased access to care provided by nurse practitioners (NPs).

Among the survey's findings:

  • A large majority favors removal of requirements that NPs work only under the supervision of physicians. Sixty-two percent of respondents support allowing NPs to prescribe medications and order diagnostic tests without such supervision. Just 17 states and the District of Columbia currently grant NPs full-practice authority, according to AANP.
  • An overwhelming majority of Americans back legislation making it easier to choose NPs as their health care providers. Seventy percent of respondents favor legislation to eliminate barriers preventing patients from choosing NPs.
  • There is widespread familiarity with NPs. Eighty percent of respondents have either seen an NP or know someone who has. More than half (53 percent) say a family member has seen one.

"These results clearly confirm what we have known anecdotally for years: American health care consumers trust NPs and want greater access to the safe, effective services they provide," AANP Co-President Ken Miller said in a news release.

The telephone survey was conducted by The Mellman Group, a Washington, D.C.-based polling firm. Its margin of error is +/-3.1 percent at the 95-percent level of confidence.

Read the AANP news release on the survey.
Read a FierceHealthcare story on it.

Read more