Teams Model of Clinical Nursing Education: An Innovative Approach.

The need for registered nurses has never been greater. Only through thoughtful academic-practice partnerships will it be possible to align the current and future demands of the workplace with the knowledge, attitudes, and skills that are required. Outdated nursing education models that treat practice partners as "real estate" and try to expose all students, in the same way, to the full array of patient populations, most often in acute care settings, do not serve the profession well. Attending to the heightened expectations for nurses to lead complex, interprofessional teams across an array of settings led to the development of the Teams Model of clinical nursing education. In this model, students match to practice partner facilities where they complete the majority of their clinical hours. They do not rotate through various settings, they do not spend precious practice time reorienting to new facilities, and they are not relegated to the periphery of the interprofessional team when in the student role. They become expected and valuable members of the care delivery team. They focus on developing depth as a nurse rather than breath across patient populations. The Teams Model is predicated on advancing academic-practice partnerships that provide a pipeline for workforce development and prepares the new graduate as a work-ready hire. Ongoing evaluation of the students' development and their knowledge acquisition is linked to practice partner assessments and provides support for this model as an innovative alternative to preparing the next generation of nurses. This partnership program builds confidence through immersion experiences in a consistent, welcoming, and prepared clinical environment, with opportunities to advance the priorities of the practice setting in addition to promoting positive patient outcomes. Benefits include student exposure to nontraditional fields of nursing and areas of critical shortage as well as the ability to pivot quickly as workforce needs shift.

Statewide political activism for California academic nursing leaders.

The California Association of Colleges of Nursing (CACN) is a not-for-profit, non-partisan nursing organization whose members are the universities' Schools of Nursing that offer baccalaureate and graduate degree programs in California. The nursing deans and directors are the individuals who attend scheduled statewide meetings and actualize the mission, vision, and governance of this organization. Starting in 2011, CACN began a journey toward greater political activism that was initiated by strategic planning. During the Spring 2017 meeting, forty-four California nursing deans/directors advanced their advocacy by attending prescheduled visits with California legislators. The goals for meetings with California policy makers included: 1. Inform them about CACN as an organization and its sphere of influence and 2. Educate them about CACN's perspective on current bills in the California legislature. This manuscript details a process to assist other state organizations to move toward political activism in support of the nursing profession from the academic nursing leadership perspective.

Preceptor and Self-Evaluation Competencies Among New RN Graduates.

Four transition-to-practice programs for new RN graduates who had not yet found employment in nursing were based on the Quality and Safety Education for Nurses (QSEN) competencies of knowledge, skills, and attitudes (KSAs). To support consistent evaluation of participants by preceptors, a 35-item tool was developed that used a 4-point scale to assess selected behaviors. This article describes the initial reliability and validity testing of the tool, which had good internal consistency, with a Cronbach's alpha of 0.92 for preceptor evaluation of participants and 0.82 when used as a self-evaluation tool. Six content experts evaluated the tool's face validity; it successfully discriminated between junior-level baccalaureate nursing students and nursing faculty. Although the tool does not exhaustively reflect the QSEN KSAs, it provides a way to assess competencies among new nurse graduates.

Academic-Practice Partnerships for Unemployed New Graduates in California.

In California, academic-practice partnerships offer innovative transition programs to new registered nurse (RN) graduates who have not yet found positions in nursing. This report describes the formation of 4 partnerships between 1 or more schools of nursing and clinical practice sites that included hospitals and nonacute care settings, such as hospice, clinics, school districts, and skilled nursing facilities. Factors facilitating the partnerships included relationships established as nurse leaders from practice and academia came together to address previous workforce issues, positive interpersonal experiences, an independent convening and coordinating organization, a shared understanding of the employment challenge faced by new RN graduates, and a shared vision for its solution. Partnerships face continuing challenges that include sustaining engagement, resource constraints, and insufficient nursing leadership succession planning. Partnership benefits include improved relationships between academia and practice, a forum to address contemporary issues in nursing education and practice advances, and stimulation of a reassessment of how to integrate ambulatory, transitional, and community-based nursing into prelicensure education.

Economic aspects of community-based academic-practice transition programs for unemployed new nursing graduates.

Four partnerships between schools of nursing and practice sites provided grant-funded 12- to 16-week transition programs to increase confidence, competence, and employability among new RN graduates who had not yet found employment in nursing. Per capita program costs were $2,721. Eighty-four percent of participants completing a postprogram employment survey became employed within 3 months; 55% of participants became employed at their program practice site. Staff development educators may find this model a useful adjunct to in-house nurse residency programs for new RN graduates.

Preparing new nurse graduates for practice in multiple settings: a community-based academic-practice partnership model.

Responding to local and national concerns about the nursing workforce, the California Institute for Nursing and Health Care worked with private and public funders and community health care partners to establish community-based transition-to-practice programs for new RN graduates unable to secure nursing positions in the San Francisco Bay Area. The goals were to retain new RN graduates in nursing and further develop their skills and competencies to increase their employability. Leaders from academic and inpatient, ambulatory, and community-based practice settings, as well as additional community partners, collaboratively provided four 12- to 16-week pilot transition programs in 2010-2011. A total of 345 unemployed new nurse graduates enrolled. Eighty-four percent of 188 respondents to a post-program survey were employed in inpatient and community settings 3 months after completion. Participants and clinical preceptors also reported increases in confidence and competence.

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.

Competence gaps among unemployed new nursing graduates entering a community-based transition-to-practice program.

Multiple reports document competence gaps among employed new RN graduates. Less is known about the competence and confidence of new RN graduates who have not yet found employment in nursing. As part of an academic/practice partnership model, 4 collaboratives provided transition-to-practice programs for newly graduated and licensed, but unemployed, RNs. The authors describe the new nurses' characteristics on program entry and discuss implications for nursing education and practice.

Academic practice partnerships: a national dialogue.

Academic-practice partnerships are an important mechanism to strengthen nursing practice and help nurses become well positioned to lead change and advance health. Through implementing such partnerships, both academic institutions and practice settings will formally address the recommendations of the Institute of Medicine Future of Nursing Committee. Effective partnerships will create systems for nurses to achieve educational and career advancement, prepare nurses of the future to practice and lead, provide mechanisms for lifelong learning, and provide a structure for nurse residency programs. This paper details the work of the American Association of Colleges of Nursing-American Organization of Nurse Executives Task Force on Academic-Practice Partnerships that has identified hallmarks of successful partnership and produced tools and shared exemplars to assist nursing leaders in developing and sustaining partnerships for the future.

Five recommendations for prelicensure clinical nursing education.

The acute shortage of RNs is both well established and projected to continue. Two primary factors contributing to the nursing shortage are insufficient numbers of faculty and insufficient clinical sites for students. Innovative academic-service partnerships are realigning these scarce resources to improve the quality of clinical education and build cultures of safety. Relationships among students, staff nurses, faculty, and the institutions where they practice are central to students' socialization, professional role development, and transition to practice. Five recommendations to strengthen these professional relationships are suggested to: reenvision nursing student-staff nurse relationships, reconceptualize the clinical faculty role, enhance development for school-based faculty and staff nurses working with students, reexamine the depth and breadth of the clinical component, and strengthen the evidence for best practices in clinical nursing education. Five key outcomes are suggested to evaluate both traditional and emerging approaches to clinical nursing education.

The clinical nurse leader: helping psychiatric mental health nurses transform their practice.

The national movement to transform the health care delivery systems must include a focus on mental health treatment. To address similar deficits across other practice domains, the Clinical Nurse Leader (CNL) role has been created. The CNL is a master's degree that prepares a nurse to use a systems perspective to improve outcomes for a cohort of patient, deliver care based on best practices, and coordinate care in a multidisciplinary team. Applying the CNL role to mental health care could help psychiatric mental health nursing be at the forefront in the transformation of mental health care delivery.

Preparing for prescriptive privileges: a standard for the psychiatric-mental health preceptorship.

TOPIC: Establishing a standard for preparation for prescriptive authority for advanced practice psychiatric nurses. PURPOSE: To outline a best practice standard for the clinical and prescriptive authority preceptorship. SOURCES: NACNS and NONPF competencies and practice guidelines. CONCLUSIONS: The authors recommend a clinical preceptorship with planned faculty monitoring, clinical logs, case studies, and group supervision to prepare the psychiatric-mental health advanced practice nurse to serve within the expanded prescribing role.

Psychiatric-mental health clinical nurse specialist practice in a public school setting.

The public school setting is increasingly becoming an entry point of contact for an array of healthcare services because it is most likely the best positioned institution to improve a community's overall healthcare. By linking behavioral healthcare services with primary healthcare services in the school setting, the psychiatric-mental health clinical nurse specialist is well suited to provide comprehensive behavioral health services.