Nurse Consultant Associates

We help nursing schools with curriculum development and national accreditation preparation

Getting Students Through the DNP Scholarly Project

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Every DNP student has to complete a scholarly project and nursing educators often struggle with mentoring students to complete relevant practice focused projects within a prescribed time period. The purpose of the scholarly project is to allow the student to demonstrate skill mastery and to synthesize knowledge gained in the DNP program. Because the DNP is a practice focused degree, the project should provide insight into practice changes that improve patient outcomes. The American Association of Colleges of Nursing (AACN) DNP Essentials states that a DNP project should focus on a practice change that affects healthcare outcomes for patients or populations through direct or indirect care, includes a sustainability plan, and an includes evaluation of the process and/or outcomes.

Critical to developing a DNP scholarly project is formulating a clear, well-developed question that is relevant to practice, can be realistically examined within two to three semesters, and contains a sustainability plan. Some project ideas are relevant to practice and may be important but the time needed to complete them will be considerably longer than that available for the DNP project. In these cases, faculty must guide students to pare and shape their ideas into smaller focused projects that can actually be completed within the allotted time frame and that form the foundation for the student’s lifelong exploration of the chosen area.

In order to be keep students focused, faculty must have both research and practice skill sets. They must understand the issues that can arise in translating evidence into practice and this only comes with knowledge of organizational practice cultures, implementation issues, and factors that may impact sustainability of the innovation. DNP projects often require a great deal of time and effort on the part of faculty as well as the student. But that time and effort can be wasted if an effective practice change isn’t sustainable. Assessing sustainably is a new area of science in healthcare and may, therefore, be unfamiliar to nursing faculty. AHRQ has an excellent beginners guide to thinking about sustainability of practice innovations https://innovations.ahrq.gov/perspectives/how-build-sustainability-innovation-process. Another excellent resource from AHRQ is a guide for sustaining and spreading (disseminating) effective practice changes https://innovations.ahrq.gov/qualitytools/how-guide-sustainability-and-spread.

All DNP scholarly projects should have a sustainability component. Without it, the innovation is likely to fade away and result in no long term improvement in healthcare outcomes. What a waste of time and effort if this happens!  

Health Policy: A Professional Responsibility

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By Dr. Barbara Sheer

Every aspect of our lives is influenced by policy. At the workplace there are policies and procedures to guide practice. Our daily lives are affected by policies at the local, state, national and international levels. Professional organizations including: American Association of Colleges of Nursing (AACN), American Association of Nurse Practitioners (AANP), American Nurses Association (ANA), National League for Nursing (NLN) and Sigma Theta Tau International (STTI) have all endorsed policy as part of the professional role. The Institute of Medicine (IOM) in their report “The Future of Nursing Leading Change, Advancing Health” (2010), recognized the importance of nursing and called for nurses to take the leadership role in improving the quality of healthcare. In the “Presidential Call to Action 2015-2017, Influence on Advance Global Health and Nursing”, Cathy Catrambone PhD, RN, FAAN, called for expanding SSTI’s influence through advocacy, policy, philanthropy and lifelong learning. She encouraged all members to contribute leadership, scholarship and research expertise to advance health policy (1).

If nurses are in a pivotal position to effect policy change why are so few involved? Involvement in policy requires both knowledge and skill. These essential elements should be incorporated into all levels of nursing education from the baccalaureate to the doctorate. Nurses must learn about the issues, identify key stakeholders, and become advocates for healthcare.

Our national political landscape is changing every day. In response many women who have not previously been involved in politics are beginning political campaigns and running for office. More nurses than ever are running for political offices and local, state, and national levels. Local, regional and national nursing organizations provide additional opportunities for policy involvement.

Nursing students must get adequate content on policy making and advocacy and develop competencies in these areas before graduation. In addition to policy, graduate nursing curricula must include content on the fiscal context in which practice takes place and address the linkages of health policy, financing, and economics to quality patient outcomes.

Nurse Consultants Associates can provide nurses and educators the skills and knowledge needed for developing leadership in the area of health policy. NCA offers a wide range of services from curriculum consultation, to courses in health policy and workshops. Our associates have first-hand experience in changing health policy on the local, national, and international levels.

Catrambone, C, https://www.sigmanursing.org/docs/default-source/BOD-Documents/call-to-action-brochure-web-2.pdf?sfvrsn=2 (April 31,2018).

 

The Rules and Regulations Conundrum: Starting a new educational program for health personnel in the United States of America

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By Dr. Rosemary Goodyear

Health care personnel in the USA require an education that assures the public that they are safe and competent providers of health care services. Each state in the nation has established rules and regulations (R&R) that guide institutions and educators in the content and process that will allow individuals, who successfully complete these programs, to become certified and/or sit for national licensure examinations. The legal authority that evokes and monitors these rules and regulations most frequently is the state board of nursing, board of education, public health authorities or a combination of these official bodies. Following successful completion of an educational program, public and/or private, each individual must attain a certificate or license to practice in that role, regardless of the work setting or title of the position fulfilled.

The R & R’s that assist programs in providing the necessary educational opportunities for interested individuals are available to the public, and can usually be accessed in an online format from the official bodies in each state. These are often published in a combination of the Nurse Practice Act, which identifies the requirements for practice in each specific state, and Articles or Standards that spell out the required administration, personnel, curriculum and steps in the process for educating the generalist nurse/registered nurse (RN) education. The academic level of education of the RN or Specialized Nurse is also included in these documents which may identify added preparation and levels of certification needed to practice in each state.

The following is a broad outline of a process to seek approval to begin a new educational program for health personnel such as (Certified Nurse Assistant – CNA; Licensed Vocational/Practical Nurse – LVN/LPN); Registered Nurse at ADN/BSN level); Certified Nurse Practitioner; Certified Nurse Midwife; Certified Registered Nurse Anesthetist; or Clinical Nurse Specialist. A consistent part of each process is a time-line to be met, assistance and reviews by board staff, hearings of acceptable proposal by the board members and types of approval ratings.

General steps in seeking approval to begin a new educational program for health personnel:

  1. Submission of a Letter of Intent from institution (public/private) to official board regulating the health personnel to be prepared.
  2. Identification and history of the institution, need for a new program preparing this type of health personnel in the geographic area of the state, and fiscal support for a sustainable program.
  3. If not a degree granting institution, the affiliation with an institution of higher education, including the collaboration with affiliate administration and faculty.
  4. Connect and work with staff of official board regulating education of health personnel during the drafting of the proposal/self-study.
  5. Identification of qualified personnel to administer and teach in the educational program.
  6. Development of curriculum for preparing health personnel following requirements as set out in the regulations of the official R & R’s.
  7. Identification and acceptance for clinical placement of students by community health care facilities.
  8. Development of policies and documentation of admission, progression, completion and evaluation of educational program.

This is a brief outline for assisting institutions or agencies interested in starting a new educational health personnel program. The language of the R & R’s is often broad and enmeshed with legal terminology and perhaps not “user friendly” for people new to starting an educational program. This is where Nurse Consultant Associates can assist the developer of new health personnel programs. A useful website that can assist in the beginning search for your state board and the R & R’s is the National Council of State Board of Nursing www.ncsb.org

Health Policy: Should Students Care?

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By Dr. Barbara Sheer

After the tragic events at Parkland Florida, the high school students mobilized and became activists. They not only went to the Florida legislature but marched on Washington DC. March For Our Lives was a nationwide protest calling for an overhaul of our gun policies. Marches and events occurred over the country with high profile star support. National news covered the event. The granddaughter of Martin Luther King spoke as well as kids as young as 7. If high school students can mobilize the nation and make a difference, can nurses have a similar impact on health care?

Legislation in Washington not only affects the health of the individuals in our nation but also global health, which may have both direct and an indirect impact on us. Economic sanctions aimed at political punishment in a variety of countries have led to increased morbidity and mortality. Did you know that on becoming president, Trump signed a global gag rule to ban international aid funding linked to abortion-related family-planning services? This could impact up to 26 million women worldwide (Chen, 2118). The “Global Gag Rule” links major funding from USAID to strict rules on avoiding facilitation or promotion of abortion in any way. USAID is a leading contributor to global family planning programs. In addition to family planning, these services include financial support for maternal and child health services, nutrition, HIV/AIDS, and prevention and treatment of tuberculosis, malaria programs. This policy change can have far reaching effects on water, sanitation and hygiene programs; and result in detrimental effects on prevention and treatment of health conditions. Trade agreements can affect the availability of key drugs for the treatment of many communicable and non-communicable diseases (Gupta, 2006).

As nurses our priority is to the patient. Being a global society, nurse need to focus on population health. We need to become activists, but how do we learn to do this? It is imperative that health policy and experiences be included in all nursing programs. Health policy is broader than just writing legislation or lobbying our legislators. Nurses must also understand the economic factors at work in policy development and the consequences of policy change. To do this, nurses must have the skills to assess the impact of policy change on health outcomes and organizational processes. DNP students, in particular, could carry out projects to critically analyze health policy results. In an article on medical students and health policy, Rajesh Gupta discussed the critical need for medical students to become policy scientists as well as good clinicians. Nursing students also must become health policy scientists and strive to improve health outcomes through health policy expertise in formulation and evaluation. Nurses need to think globally and act locally and we can learn from the high school students to raise public awareness of policies.

NCA can help you in revising health policy courses or curriculum. NCA consultants have experience in policy and global health and can help you to tailor nursing education programs to enhance current health policy courses and/or thread policy throughout the curriculum.

Chen, M (2018, March 6). Trump’s Abortion Gag Rule Is Hurting Reproductive Rights Around the Globe. Retrieved from https://www.thenation.com/article/trumps-abortion-gag-rule-is-hurting-reproductive-rights-around-the-globe/

Gupta R (2006) Why Should Medical Students Care about Health Policy? PLoS Med 3(10): e199. https://doi.org/10.1371/journal.pmed.0030199

Keywords: nursing education, curriculum, policy, global health

The Flipped Classroom

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The Flipped Classroom

 Flipping the classroom is all the rage in education these days. But what does it mean and should you do it? In the flipped classroom approach, students study course material outside of class using required readings, video lectures, podcasts, or other assignments. Rather than lecture during class time, the instructor facilitates learning by coaching students through course materials either individually or in groups and promoting active learning strategies.

One of the benefits of using a flipped classroom is to improve student attention span. Student’s today have grown up with the internet, video games, and social media. They are used to using technology for communicating and learning. In the flipped classroom, students engage in lower levels of cognitive work, such as gaining knowledge (see Bloom’s revised taxonomy, 2001), outside of the classroom while higher levels of cognitive work, such as application and analysis, are emphasized in the classroom.

Some faculty are unsure of how to design a course using the flipped classroom approach while others are concerned over the amount of time it may take to design and teach such as course. I recently read an article “Find Time to FLIP!’ by Barbi Honeycutt PhD on three simple strategies to flip a course that takes only 10 minutes to implement in your classroom You can find her article here http://barbihoneycutt.com/3-flipped-strategies-can-10-minutes-less/.

Flipping the classroom can enhance active learning but should be undertaken thoughtfully and strategically. Using the flipped approach, students take on an active learner role and this may be an unfamiliar and uncomfortable role for some. Faculty may also feel intimated or burdened by moving from lecturer to facilitator and coach. There are many articles and other resources available on the web to help you through the process of developing and implementing a flipped classroom. NCA can help you to develop or revise your curriculum to incorporate and evaluate active learning strategies.

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