Optimization of faculty practice.

Nursing faculty practice encompasses multiple roles including direct and indirect provision of nursing/clinical services, research, education, consultation, administration, and other collaborative agreements. While faculty practice is encouraged by both American Association of Colleges of Nursing and National Organization of Nurse Practitioner Faculties, not all universities and colleges incorporate faculty practice as part of academia. The purpose of this paper is to discuss how one midwestern University optimized faculty practice over a four-year period by improving supporting infrastructure, contracts, aligning faculty and practice partners, and accountability. Pertinent data, decisions, and processes for each area are described here as well as the management of revenue generated.

The trifecta: harnessing the power of philanthropy, joint appointments, and practice to ease the faculty shortage: academia, practice, and philanthropy.

Partnerships between clinical facilities and academia are critical in supporting undergraduate and graduate nursing education. The authors discuss a unique model that blends academia, clinical practice, and philanthropy and uses grateful patient benefactors to assist in providing clinical instructor support for affiliated nursing schools. The authors review the process of proposal development, solicitation of benefactors, and results of the model.

A 10-year review of four academic nurse-managed centers: challenges and survival strategies.

Since 1985, there has been rapid growth in nurse-managed health centers (NMHCs). Many were established by academic schools of nursing, and several have closed. The Independence Foundation undertook this study to identify the challenges and survival strategies employed by four academic nurse-managed center grantees during a 10-year period. Data from Foundation records, interviews with directors and staff from the centers and the National Nursing Centers Consortium, a focus group with center founders, and field notes were analyzed for themes related to the centers' challenges and survival strategies. Although the centers faced many challenges from the sociopolitical environment, the community, and their parent organizations, the most difficult challenge was achieving financial sustainability, which was attainable only by obtaining cost-based reimbursement. Because of existing health policies, that was possible only through organizational restructuring and affiliation with an existing federally qualified health center. The future of nursing centers depends upon favorable health policies, data documenting centers' effectiveness, and adequate preparation of the next generation of nursing center directors and practitioners.

Down the rabbit hole: examining outcomes of nurse midwifery care.

Care of the laboring woman and subsequent birth interventions have generally been based on tradition rather than a systematic examination of the cost-effectiveness of the interventions. This retrospective study examined the outcomes of nurse midwifery care at a large metropolitan university clinic setting. Findings suggest that more sensitive cost and quality indicators of nurse midwifery care need to be developed, and the effect of these on outcomes needs to be elucidated.

Academic nurse-managed centers: approaches to evaluation.

A comprehensive evaluation plan was developed to assess the outcomes of a multiuniversity project to support the development of academic nurse-managed centers (ANMCs). The evaluation included measuring ANMC impact on the clients and communities served, on students, and on the sponsoring faculties and universities. This article includes a discussion of the processes used in evaluation plan development, the variables measured, the tools developed to measure selected variables, and a summary of evaluation findings. Recommendations for use of selected evaluation components across ANMCs are presented.

An evaluation of critical care lecturer practitioners.

The aim of this study was to evaluate the educational value and impact upon staff of critical care lecturer practitioners. Data were collected through three staff focus groups (n=21) and a questionnaire completed by 70 members of trust or university staff. A majority of respondents felt that the lecturer practitioner roles had considerable effect upon adult critical care services. Six main categories of findings were derived from analysis and integration of both focus group and questionnaire data--development of knowledge; staff support; being a teacher; developing and maintaining the workforce; role improvement plus removal of the lecturer practitioner role. Many of these findings concur with the limited quantity of evaluative literature on the lecturer practitioner role. The authors produced a report recommending continued funding for existing lecturer practitioner posts; introduction of more lecturer practitioner posts should be considered, and further role evaluation should be conducted at both a local and national level.

The consistency of change in the development of nursing faculty practice plans.

Nursing faculty practice plans need to be inherently flexible to meet the changing needs of nursing schools and the external clients of the practice plans. The University of Texas-Houston Health Science Center (UT-Houston) School of Nursing has constructed two integrated models of faculty practice to meet the challenges of change. Our linkage model with outside agencies and our academic nursing center provided in excess of one million dollars of support to the School of Nursing in fiscal year 1992-1993. Flexibility in our linkage model is discussed in such areas as the negotiation process for contracts with outside agencies, methods of payment for services, calculations of cost recoveries, methods of setting consultant rate levels, revisions of fund-disbursement policies, and development of fund-tracking systems. UT-Houston School of Nursing's nursing center model is based on a business plan and was established without outside funding assistance. Over time, the areas of concentration have changed because of changing community needs and market conditions. Its revenues depend on marketing efforts by the clinic staff. Evaluation and outcome research, to be based on computerized financial and patient record information systems, are considered critical elements in maintaining the UT-Houston cutting-edge leadership as an academic nursing center.

Faculty practice: creating a new culture.

This article provides specifics on the development of a clinical track for faculty appointments at the University of Pittsburgh. The criteria to be used for appointment and promotion on the clinical track are discussed along with the practice requirements of 60 hours per term of participation in and responsibility for direct care of patients. The purposes of faculty practice are set forth along with the formation and functioning of a Faculty Practice Council which handles decisions related to faculty practice. Results of the first year after implementation of a clinical track showed that 64 per cent (18) of the faculty had met all of their faculty practice obligations; of the remaining 36 percent (10) who had not, a variety of circumstances were cited. The Income to the School of Nursing for faculty practice, although modest, has helped to highlight that practice is valued and an integral part of the faculty role.

Public health service administration and academia. A joint venture.

Joint ventures between service and academia are designed to enhance the quality of client services, enrich faculty teaching experiences and skills, and strengthen communication channels. The joint venture described in this article is an example of how public health nursing services and academia can be united through faculty participation in administration. Included in the discussion are the impetus for the project, the contract negotiations, the positive outcomes and disadvantages of the venture, and questions that should be raised when a similar venture is considered.

Nursing faculty practice: an organizational perspective.

After reviewing the faculty practice literature of the 1980s and finding philosophical support for practice but also growing concerns about faculty role overload, the authors report a study to identify organizational factors that influence the role expectations of faculty members about practice. A survey was sent to the deans or directors of all National League for Nursing--accredited baccalaureate nursing programs (n = 462). Of the 356 respondents (78 per cent), 224 (63.3 per cent) reported that their school had practicing faculty, but only 20 schools (8.8 per cent) required practice. Written faculty practice plans were reported by 23 schools (10.2 per cent), and nursing centers by 41 schools. Thirty-six respondents (16 per cent) reported that practicing faculty generated revenue for the school. Practice was required for promotion in 15.8 per cent and for tenure in 15.3 per cent of all schools surveyed. The study showed significant direct relationships between master's and doctoral programs and practicing faculty, but there was an inverse relationship between the presence of a health science center and schools with practicing faculty. Organizational factors relating to both the number and per cent of faculty who practiced included requiring practice, having a practice plan, and having practice as a criterion for promotion and for tenure. Revenue generation and presence of formalized practice arrangements were related to the number of faculty who practiced but not the per cent of the total faculty who practiced. The study's findings have implications for nursing education in designing organizational structures and rewards that support faculty practice.

The nurse teacher's role in the practice setting.

In the light of the education reforms brought about by the implementation of Project 2000 it is essential that nurse teachers critically appraise their role and function. In particular, they need to give careful consideration to their role in relation to the practice setting. Whilst the English National Board (1989) indicate that nurse teachers should retain their clinical competence and be able to teach in both classroom and practice settings, little has been written in respect of the implications of this directive. This paper considers the issue of clinical competence and explore some of the different dimensions of the nurse teacher's role in the practice setting, in respect of teaching, providing educational support and facilitating good practice. Finally, some of the issues relating to the successful fulfilment of this role are identified for consideration.

Nursing faculty practice in the Houston Linkage Model: administrative and faculty perspectives.

The authors describe a model for the development and implementation of faculty practice, focusing on administrative and faculty parameters of concern in its establishment. Administrative parameters include mission and purpose, benefits to nursing education and nursing service, contractual arrangements, legal issues, use of revenues, and evaluation. The case example illustrates faculty concerns and mentorship, maintenance of clinical skills, patient care, facilitation of research for promotion/tenure, and benefits.

Nurse faculty practice: from theory to reality.

This article discusses the developmental stages involved in moving the concept of faculty practice from theory to reality. Bennis, Benne, and Chin's theories for planned change and Hage's theory for organizational change with a dominant coalition form the theoretical bases for this redical innovation. Smith's Time Line serves as the framework for tracing the development of the plan over its 6-year history. The political, logistic, and financial promoters and constraints at each stage of development are identified. Faculty reaction to the idea of faculty practice is presented, and the mechanisms used to bring about group consensus are described. The key elements for the successful transition of this plan are a small and resilient group of faculty planners and adaptation of existing organizational systems to accommodate nursing's interests. Finally, the practice plan is presented at its present stage of development with its future goals.