VA Nursing Academy Annual Conference August 2010 Transformation and Innovation through Academic Partnerships

1. VA Nursing Academy Annual ConferenceAugust 2010Transformation and Innovation through Academic Partnerships Chicago, Illinois

2. VA Nursing Partnership: The Embedded Faculty Model an Innovation for Clinical EducationPartnership for ChangeNorth Florida/South Georgia Veterans Health SystemUniversity of Florida College of NursingGainesville, Florida

3. Authors and Contributors VA-UF Nursing Academy Directors : Dr. Maude Rittman Dr. Maxine Hinze New to Partnership: Ms. Robin Riffee � new VA Director as of May 2010 Dr. Linda Cowan � new EBP Coordinator Ms. Lisa Bagnall � new VANA Faculty VANA Faculty: Carla Anderson, MN, CNL, ARNP Thomas Bedard, MSN, CEN Justina Chappell, MSN, FNP-BC Stefanie Coffey, DNP, MBA, FNP-BC Sarah Espin, MSN, CCRN Michele Taylor-Caldwell, DNP, ANP-BC Julia Tortorice, MSN, MBA, CNAA-BC Mary Ann Walker, PhD, ARNP

4. Background � Why a Partnership? National Nursing Shortage Greater need as populations age and nurses retire Inability to expand nursing school enrollments due to faculty shortage Faculty retirements Salary discrepancies in academic settings versus clinical settings

5. Nursing Center of Excellence for VA-UF Nursing Academy Partnership Goals: Expand baccalaureate nursing student enrollment Improve recruitment and retention of nurses in the VA system Enhance nursing practice through faculty and nursing staff professional development Improve quality of care for Veterans

6. VA-UF Nursing Center of Excellence Core Programs

7. Strategies to Address the Nursing Faculty Shortage Advocacy � inform the public Education Partnerships � school-to-school; school and external agency Academic Innovation � strategies to improve upon efficiency External Funding � outside monies

8. Embedded Clinical Education Faculty Model

9. Embedded Faculty Model Collaborative Partnership between a school and external agency External Funding Addresses some of the background issues and barriers to the nursing shortage

10. Development of the Embedded Faculty Model Not totally new � positive aspects of other models Reinvention and adaptation Dorothy Smith Luther Chrisman Vanderbilt model Dedicated Education Unit - DEU

11. What is it? The Embedded Clinical Faculty Model is designed to increase student enrollment, retain and recruit nurses to the bedside and to improve the quality of care Faculty members are an integral part of both the educational unit as well as the clinical agency on a designated unit Have dedicated teaching responsibilities for nursing students Have dedicated clinical unit responsibilities

12. Embedded Clinical Faculty Members Long-lasting and meaningful relationships with nursing staff and leadership Resource to assist in the management of complex patients Committed and dedicated to the clinical agency Conduct evidence-base practice projects Embrace and advocate the academic mission and curriculum Facilitate staff and student educational experiences

13. Goal � Expand & Enhance Faculty and Professional Development Experienced nurses are given the education and/or experience to become faculty members Seminars by the College Mentoring plans Teaching certificate Scholarship opportunities Accelerated Learning Workshop Travel Money for presentations & workshops As of July 2010 � Thirteen faculty have been hired in the partnership; Five have left the partnership but remain at VA; Four were hired from outside of the VA.

14. Goal - Increase Nursing Student Enrollment Ability to admit more students due to greater number of faculty and/or more clinical sites Enhanced clinical experiences due to trust and team work of clinical faculty with staff and nursing students

15. Increased Student Enrollment by Year

16. Faculty & Students Engaged in VA-UF Partnership

17. Goal: Enhance Nursing Practice & Improve Quality of Care Model Units with Embedded Faculty �see units with �fresh eyes�; change agents EBP Program � staff nurse training, support in identifying clinical problems & in conducting EBP projects Clinical Simulation � enhanced competency based education; real-life scenarios Clinical Expert Resources

18. Embedded Clinical Faculty 4 Medical Units 1 Surgical Unit 1 Critical Care Unit 1 Psychiatry Unit 1 RN Residency Coordinator 1 EBP Coordinator 1 Simulation and Skills Lab Faculty

19. Unit Based Projects to Improve Quality Patient Care IV administration of potassium (concentration issues) Insulin administration & documentation Nutritional supplements & dietary improvement Interdisciplinary team meetings for psychiatry Supplies and supply room reorganization Aspiration precautions Noise reduction project Handoff communication improvement Unit based concept mapping to improve core measure (Heart Failure)

20. Nurse Led Interdisciplinary Wound Care Project Wound Module Development & Education for Staff Nurses Develop better inter-rater reliability for assessing wounds and risk for skin breakdown Better communication with Wound Team Cameras to document and transmit information to Wound Team Decrease in pressure ulcer development

21. Evidence-Base Practice Program Dedicated EBP Coordinator Develop EBP Recommendation Report and resources for nursing EBP 2-day Course for RN Residents Introduction to EBP for Nursing � 2 hour online course for CEUs Unit Base Practice Councils � coaching, development, mentoring, socialization PICO Question Development

22. EBP Projects by Residents & Staff Comparison of negative pressure wound VAC with wet-to-dry dressings in post surgical patients Clinical pathway for CABG/Valve patients in the CT step down unit Method of temperature measurement in critically ill patients Flush solutions for enteral tube feeding patients

23. Clinical Simulation Coordinator Assist with all simulation teaching in Nursing Resource Center Develop research project with Honor Students evaluating simulation learning in RN Residents Critical Care Course � ACLS and other simulation activities RN Residency Simulation - for health assessment and patient care management Unit Based Simulation - with unit specific scenarios

25. Goal - Increase Recruitment and Retention Increased student rotations & increase in VALOR applications Positive clinical experiences as evaluated by College and VA Improved staff nurse satisfaction & RN resident satisfaction Year long RN Residency program *increased recruitment of BSN nurses *increased retention of new nurses

26. RN Residency Program 

27. Outcomes Increased enrollment and additional clinical groups at the VA Development of 12 month Residency Program Unit Based EBP Projects Increased scholarly productivity � research, publications, posters, and presentations

28. Scholarly Work Aspects of the partnership have been presented at numerous local, regional and national meetings: FONE Florida Magnet Conference Dorothy Smith Lectureship AACN Baccalaureate Conference CON Malasanos Research Day INASP Publications and Grants: Interdisciplinary Wound Grant Education Innovation Grant Two articles in press Three articles submitted or in development

29. Successful Partnerships Shared Vision Common Values and Goals � Advisory Board with partnership and stakeholder representation Communication � extensive and often � Quarterly Newsletter Melding of Cultures Change Passion Determination, Dedication, Diligence

30. Future Directions Focus Group Evaluation with Stakeholders -Faculty, Staff, Students, Residents, Leadership Cost Effectiveness Projects Sustainability Projects

31. Sustainability and Replication Expand the model to other agency affiliations with a shared fiduciary responsibility? Article in Nurse Educator (2010) July-August

32. It takes a partnership to raise and educate the next generation of nurses! Anonymous

33. Acknowledgements VA Office of Academic Administration VA-UF Advisory Board NFSGVHS Nursing Education Department Chief Nurses, Model Unit Nurse Managers and Unit Leadership, Preceptors Faculty and Staff at UF College of Nursing