Authors

  1. Coke, Lola A. PhD, ACNS-BC, FAHA, FPCNA, FNAP, FAAN

Article Content

In 2016, the American Association of Colleges of Nursing commissioned a study and published a report that described a call to action for transforming healthcare through strong academic-practice partnerships.1 The goal of this report was to provide "a fresh understanding of today's landscape and identify a path for achieving an enhanced partnership between academic nursing and academic health centers to advance integrated systems of care, achieve improved health outcomes, and foster new models for innovation" (p. 2). The recommendations from that report included embracing a new vision for academic nursing as a full partner in healthcare delivery, education, and research in partnership with health systems; enhancing the clinical practice of nursing faculty; and partnering in the preparation of future nurses. Recommendations also include investment in nursing research, integration of research into clinical practice, and promotion of an advocacy agenda to support this new era of academic nursing as partners with health systems. As I reviewed this report in preparation for more robust conversation with practice partners, my Clinical Nurse Specialist (CNS) hat went on and, I thought, we participate in all these things! What a better role to assist deans and Chief Nursing Officers to integrate academe and practice! Certainly, in large academic medical centers, these partnerships are well established and CNSs have been an integral part of this work. However, for those of us in nursing education in smaller markets with separate colleges or schools of nursing and smaller health systems, there is still work to be done. The CNS should definitely be at the table to strengthen these partnerships and help create evidence-based strategies.

 

Strategies outlined in the report that guide the development of clinical practice in an academic nursing partnership include (1) establishing clinical leadership positions to link faculty to clinical practice, (2) facilitating joint clinical program development especially in ambulatory and population health, (3) expanding clinical integration with joint appointments, and (4) promoting and expanding nurse-managed health clinics.1 These are all excellent ways to bridge relationships, strengthen expertise of faculty, and provide additional clinical placement sites. The CNS can play an integral role in the development of these positions and serve as a leader and mentor to clinical faculty. The CNS can also work collaboratively with academic faculty to plan meaningful clinical experiences especially in nontraditional clinical sites.

 

Of particular interest to this author is the preparation of the nurses for the future, another recommendation in the report. This recommendation addresses not only creating a pipeline for student nurses but also the development in leadership in the future of those nurses as they aspire to further education. It also recommends encouragement and streamlined approaches to allowing adjunct faculty opportunities to further their education as mentors or in advancing their faculty role.

 

Several practice partners have signaled to me that nurses are leaving after 1 to 1.5 years at the bedside. This trend needs to be examined and strategies need to be developed to improve retention rates. Anecdotally, the thinking is that it is more than just a need to build resilience in our graduating nurses. New mechanisms to socialize students within a health system and deliberate planning of realistic experiences with a caseload of patients are just 2 ideas being developed with our practice partners. With the nursing workforce shortage and impact of the COVID pandemic on healthcare, now more than ever, these academic-practice partnerships are critical. As a leader in academe, I have been working closely with our practice partners to identify particular areas experiencing extreme shortages. We are working together to plan both simulation experiential learning and expanded clinical placements to prepare students who are interested in these gap areas, including ambulatory care and perioperative nursing. We will obtain additional clinical placements targeted in these gap areas and develop specific experiential learning modules to better prepare students for these environments. Together, we are planning how we can work together to increase our undergraduate nursing capacity. We will work together to develop creative ways to socialize students and teach time management skills for typical acute care caseloads to better prepare the student. Finally, we are planning to develop specific interprofessional simulation and clinical experiences to enhance teamwork and communication skills. The CNS team at our practice partner institution will be right alongside us to develop realistic and contemporary experiences and simulation modules that align with student nurse transition to practice and onboarding. Finally, our practice partner is establishing a scholarship/grant mechanism to help students with their tuition in return for a commitment to work in the health system for 2 years.

 

This strong partnership is a win-win for our students, our college, the healthcare system, and the community at large because we can produce more nurses. Along the way, we will work collaboratively to develop evaluation metrics to gauge the success of the partnership and make modifications as needed to ensure student and partnership success. The American Association of Colleges of Nursing report provides an organizational self-assessment tool so colleges and health systems can evaluate their critical priorities and work together to meet those priority goals. In addition, Polancich and colleagues2 published their work describing innovative approaches and a framework to evaluate academic-practice partnerships. The framework allowed for the development of partnership vision and mission statements, and then priorities and objectives were developed under 4 pillars including engagement, quality, financial, and advancement of knowledge. Once the priorities and objectives were identified, an evaluation matrix is developed. The authors used the Centers for Disease Control and Prevention evaluation framework that included these steps: engage stakeholders, describe the program goals, focus the evaluation design, gather credible evidence, justify conclusions, and ensure use and share lessons learned.3 The authors concluded that, by using the framework, they were able to quantify and present partnership objectives. Metrics were both just in time and aggregate, and helped to determine the overall impact of the partnership. They also indicated that communication was strengthened and quantifiable quality improvements were made.

 

In conclusion, now is the time for all colleges of nursing and health systems to partner together to develop strategies to combat the nursing workforce shortage but, most importantly, work together to problem solve identified issues that can impact both.

 

References

 

1. American Association of Colleges of Nursing. Advancing Healthcare Transformation: A New Era for Academic Nursing. Washington, DC: American Association of Colleges of Nursing; 2016: https://www.aacnnursing.org/Portals/42/AACN-New-Era-Report-pdf. Accessed May 15, 2022. [Context Link]

 

2. Polancich S, Miltner R, Poe T, Harper D, Moneyham L, Shirey M. Innovations in evaluating nursing academic practice partnerships. JONA. 2021;51(6):347-353. [Context Link]

 

3. Program Performance and Evaluation Office (PPEO), Centers for Disease Control and Prevention. A framework for program evaluation. 2018. https://www.cdc.gov/eval/framework/index.htm. Accessed May 16, 2022. [Context Link]