Using innovative models in transition to practice and Master's Entry programs to teach ambulatory and primary care nursing.

With advancements in health care and changes in reimbursement that contribute to shorter hospitalizations, health care delivery is increasingly shifting to other settings to include skilled nursing, home care, and outpatient areas. There is a well-documented shortage of hospital-based capacity for clinical placements in California. The need for clinical placements is creating an opportunity to utilize ambulatory care settings as innovative alternative learning experiences for prelicensure nursing students. Care coordination, health coaching, and population health management are examples of skills useful for all RNs that ambulatory care settings offer as learning experiences for nursing students. The skills and knowledge students gain in ambulatory care are valuable for a wide range of employment settings. Additionally, these alternative settings provide faculty other clinical placement options since acute care placements are difficult to secure and sustain. The University of San Francisco (USF), School of Nursing and Health Professions (SONHP) developed two educational models to prepare nurses for complex disease management. One was a post-graduate new RN program that focused on outpatient/ambulatory care, the Transition to Practice Program (TTP). The other was a prelicensure Master's-Entry Master's of Science in Nursing (ME-MSN) program that has an ambulatory and acute care pathway.

Collaborative academic-practice transition program for new graduate RNs in community settings: lessons learned.

In 2010-2011, leaders from California academic and practice settings and additional community partners collaboratively developed four 12- to 16-week transition programs for 345 new registered nurse (RN) graduates who had not yet found employment as nurses. Program goals were to increase participants' confidence, competence, and employability and expand the employment landscape to nontraditional new graduate settings. One program focused exclusively on community-based settings and was completed by 40 participants at clinics and school sites; all participants secured RN jobs. Key lessons learned go beyond the impact for participants and relate to changing the nursing culture about career path models for new graduates, troubleshooting regulatory issues, the potential for new graduates to help transform nursing, and advancing academic-practice partnerships and supporting practice sites. The community-based transition program continues to provide opportunities for new RN graduates and model an approach for transforming nursing practice.