Advancing the clinical nurse leader model through academic-practice-policy partnership.

The nursing profession is tasked with identifying and evaluating models of care with potential to add value to health care delivery. In consideration of this goal, we describe the Clinical Nurse Leader (CNL) initiative and the activities of a national-level CNL research collaborative. The CNL initiative, launched by the American Association of Colleges of Nursing in collaboration with education and healthcare leaders, has delineated CNL education curriculum and practice competencies, and fostered the creation of academic-practice-policy partnerships to pilot CNL integration into frontline nursing care delivery. The partnership has evolved into an Agency for Healthcare Research and Quality affiliate practice-based research network, the CNL Research Collaborative, which links research, policy, education, and practice stakeholders to advance the CNL evidence base. We summarize foundational CNLRC research to explain CNL practice, quantify CNL effectiveness, and bring clarity to how CNLs can be implemented to consistently influence care, quality, and safety.

Impact of the COVID-19 Pandemic on the Future of Nursing Education.

Nursing is the largest health profession, with nearly 4 million providers practicing across acute, primary, and public health care settings. In response to the pandemic, nursing schools halted on-site course delivery and redesigned programs to attenuate risks to students and faculty. Key challenges faced by schools included financial cutbacks, rapid increases in online learning technology, maintaining student academic progression, disruption to clinical learning opportunities, and meeting accreditation standards, while addressing the stress and loss experienced by faculty, staff, and students. Despite challenges, nursing organizations provided guidance for decision making, new learning resources, and faculty development opportunities. Schools of nursing leveraged their resources to redesign nursing curricula, strengthen partnerships for student clinical experiences, and address needs of the community. Nursing education will look different from its prepandemic profile in the future. Lessons learned during the pandemic point to gaps in nursing education, particularly related to disaster and public health preparedness, health equity, and technology. The American Association of Colleges of Nursing's new Essentials-standards for professional nursing education-were finalized during the pandemic and reflect these lessons. The need for nurse scientists to conduct emergency response research was made evident. The importance of strong academic-practice partnerships was highlighted for rapid communication, flexibility, and responses to dynamic environments. For the future, nursing education and practice must collaborate to ensure that students and practicing nurses are prepared to address emergencies and pandemics, as well as the needs of vulnerable populations.

The clinical nurse leader: a catalyst for improving quality and patient safety.

AIM: The clinical nurse leader (CNL) is a new nursing role introduced by the American Association of Colleges of Nursing (AACN). This paper describes its potential impact in practice. BACKGROUND: Significant pressures are being placed on health care delivery systems to improve patient care outcomes and lower costs in an environment of diminishing resources. METHOD: A naturalistic approach is used to evaluate the impact the CNL has had on outcomes of care. Case studies describe the CNL implementation experiences at three different practice settings within the same geographic region. RESULTS: Cost savings, including improvement on Centers for Medicare and Medicaid Services (CMS) core measures, are realized quickly in settings where the CNL role has been integrated into the care delivery model. CONCLUSIONS: With the growing calls for improved outcomes and more cost-effective care, the CNL role provides an opportunity for nursing to lead innovation by maximizing health care quality while minimizing costs. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing is in a unique position to address problems that plague the nation's health system. The CNL represents an exciting and promising opportunity for nursing to take a leadership role, in collaboration with multiple practice partners, and implement quality improvement and patient safety initiatives across all health care settings.

Changing the face of nursing faculty: minority faculty recruitment and retention.

Critical shortages in the nursing workforce pose life-and-death decisions for health care institutions. Similar shortages of nursing faculty, particularly nursing faculty with doctoral degrees, confront schools of nursing. Competition among health care institutions and schools of nursing for master's- and doctorally prepared nurses is fierce. Credentialed minority faculty are in even greater demand. Rising salaries and increasing opportunities outside of academia present significant barriers to schools of nursing seeking to recruit and retain minority nursing faculty. Challenges to increasing the number of minority nursing faculty surface very early in the pipeline and include competition among health professions and other disciplines for minority students. Successful long-term strategies to increase the number of minority nursing faculty must include strategies to attract higher numbers of minority students into baccalaureate, master's, and doctoral nursing programs. Several initiatives to increase minority student enrollment in the health professions are highlighted. Finally, strategies for recruiting, empowering, and retaining minority nursing faculty by schools of nursing are presented.

Disaster competency development and integration in nursing education.

Nurses, because of their nursing education and perspective practicing in multiple roles and settings, are uniquely qualified for mass casualty preparedness and response. Educating the current 2.7 million registered nurses and all future nursing graduates is a daunting task. Nursing education must ensure that graduates are prepared with the necessary knowledge and skills for mass casualty incidents. Four key entities are essential for education's successful implementation of disaster preparedness: education and professional organizations, accreditation and regulatory bodies, schools of nursing, and continuing education providers. This article examines the role each of these key entities plays in the development of a nursing workforce prepared for mass casualty response. In addition, the International Nursing Coalition for Mass Casualty Education (INCMCE) registered nurse (RN) competencies for mass casualty incidents and guidelines for integrating these competencies into the nursing education curricula are presented.

Impact of new regulatory standards on advanced practice registered nursing: the APRN Consensus Model and LACE.

Advanced practice registered nurses (APRNs) represent a crucial resource to meeting growing health care needs. Such resources must be used to the full extent and in the most effective way possible. Through the development of the Consensus Model for APRN Regulation: Licensure, Accreditation, Certification and Education (LACE), nursing is assuming a leadership role within the health care system and participating as an equal partner in redesigning health care. When fully implemented, the Consensus Model will allow APRNs to practice to the full scope of their education and more easily move from one state to another, increasing access to quality health care for all populations.

Department of Health and Human Services releases new immersive simulation experience to improve infection control knowledge and practices among health care workers and students.

In this article, we review a newly developed evidence-based immersive simulation experience for use with health care personnel and students. The article provides information necessary for infection control professionals to understand the development process of the training. Evidence supporting the use of such training is provided, and opportunities to integrate this training into the health care setting and classroom are discussed.

Using the Clinical Prevention and Population Health Curriculum Framework to encourage curricular change.

The Healthy People Curriculum Task Force was established in 2002 to encourage implementation of Healthy People 2010 Objective 1.7: "To increase the proportion of schools of medicine, schools of nursing and health professional training schools whose basic curriculum for healthcare providers includes the core competencies in health promotion and disease prevention." In 2004, the Task Force published a Clinical Prevention and Population Health Curriculum Framework ("Framework") to help each profession assess and develop more robust approaches to this content in their training. During the 6 years since the publication of the Framework, the Task Force members introduced and disseminated it to constituents, facilitated its implementation at member schools, integrated it into initiatives that would influence training across schools, and adapted and applied the Framework to meet the data needs of the Healthy People 2010 Objective 1.7. The Framework has been incorporated into initiatives that help promote curricular change, such as accreditation standards and national board examination content, and efforts to disseminate the experiences of peers, expert recommendations, and activities to monitor and update curricular content. The publication of the revised Framework and the release of Healthy People 2020 (and the associated Education for Health Framework) provide an opportunity to review the efforts of the health professions groups to advance the kind of curricular change recommended in Healthy People 2010 and Healthy People 2020 and to appreciate the many strategies required to influence health professions curricula.

The roles of healthcare professionals in implementing clinical prevention and population health.

Across the health disciplines, clinical prevention and population health activities increasingly are recognized as integral to the practice of their professions. Most of the major clinical health professions organizations have begun incorporating clinical prevention and population health activities and services into educational curricula, the accreditation process, and training to affect clinical practice. Students in each health profession need to understand the roles played by those in other health professions. This understanding is a prerequisite for better communication and collaboration among the professions and for accomplishing the educational objectives included in Healthy People 2020 and organized using the Education for Health framework. To help accomplish these goals, this article summarizes each health profession's contributions to the field of prevention and population health, explains how the profession contributes to interprofessional education or practice, reviews specific challenges faced in the provision of these types of services, and highlights future opportunities to expand the provision of these services. Several general themes emerge from a review of the different health professions' contributions to this area. First, having well-trained prevention and population health professionals outside of the traditional public health field is important because prevention and population health activities occur in almost all healthcare settings. Second, because health professionals work in interprofessional teams in the clinical setting, training and educating all health professionals within interprofessional models would be prudent. Third, in order to expand services, reimbursement for health promotion counseling, preventive medicine, and disease management assistance needs to be appropriate for each of the professions.

Positioning advanced practice registered nurses for health care reform: consensus on APRN regulation.

Advanced practice registered nurses (APRNs) have positioned themselves to serve an integral role in national health care reform. This article addresses both the policy and the process to develop this policy that has placed them in a strategic position. A successful transformation of the nation's health system will require utilization of all clinicians, particularly primary care providers, to the full extent of their education and scope of practice. APRNs are highly qualified clinicians who provide cost-effective, accessible, patient-centered care and have the education to provide the range of services at the heart of the reform movement, including care coordination, chronic care management, and wellness and preventive care. The APRN community faces many challenges amidst the opportunities of health reform. However, the APRN community's triumph in reaching consensus on APRN regulation signifies a cohesive approach to overcoming the obstacles. The consensus model for APRN regulation, endorsed by 44 national nursing organizations, will serve as a beacon for nursing, as well as a guidepost for consumers and policymakers, on titling, education, certification, accreditation, and licensing for all four APRN roles.

Implementing innovation through education-practice partnerships.

Calls to transform the healthcare system and evolve the preparation of healthcare professionals have increased in recent years. In response to the concerns and recommendations voiced in the series of national reports, the American Association of Colleges of Nursing (AACN) Board of Directors initiated a series of task forces from 1999-present. The pilot Clinical Nurse Leader (CNL(trade mark)) initiative which grew out of the work of the task forces represents an exemplary national partnership between nursing education and practice. The CNL is a new nursing role being developed and piloted by the AACN in collaboration with education and practice leaders. An AACN task force, comprised of equal representation from education and practice, is currently working with 86 partnerships, including 92 schools of nursing and 191 health care institutions, to implement the CNL initiative. All of the partnerships have committed to collaboratively develop a master's CNL degree program and to transform one or more units within the healthcare institution utilizing the new CNL role. Early patient care outcomes from the initiative are positive. However, one additional outcome realized from the initiative has been the coming together of nursing education and practice to achieve a common goal-improved patient care outcomes.