VA Nursing Academy: Enhancing Academic Partnerships
The James A. Haley Veterans' Hospital (JAHVH) and the University of South Florida College of Nursing (CON) have partnered in response to the request for proposals to establish a VA Nursing Academy's Enhancing Academic Partnerships Program (VANA).
This proposed VANA will build on the existing upper division traditional and accelerated second degree programs at the CON. The proposed VANA would expand the already successful programs by providing additional resources to learn how to meet the needs of the ever growing population of service members returning from Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF). The VANA would allow for the attainment of the following aims:
1) Increase JAHVH recruitment and retention of baccalaureate prepared registered nurses through enhanced curriculum and clinical experiences; 2) Expand JAHVH, and CON teaching faculty; 3) Provide JAHVH nurses with opportunities for a continuum of nursing education.
The VANA will use the unique, highly successful and innovative Burns Clinical Collaborative Model (Burn's Model). This model, launched by the CON in 2001 in partnership with 15 health care hospitals/systems, facilitates practice collaboration among health care facilities in the Tampa Bay area and provides clinical training preparation of undergraduate nursing students to: 1) streamline the process of providing nursing students with a wide range of clinical experience; 2) limit the need to provide student supervision across a broad geographic area; and 3) provide area hospitals with the opportunity to fill vacancies with nursing graduates who are familiar with their procedures and require little or no post-graduate training.
The JAHVH is a Level I Polytrauma site. Level I designated sites are VA Medical Centers that provide intensive acute and rehabilitative care to veterans and service members who have experienced severe injuries as a result participating in OIF/OEF. The JAHVH nursing service has been a leader in developing programs and supporting other Veteran's Administration hospitals in learning about blast injury and was instrumental in creating a consortium among all Level I facilities as well as initiating a national conference on the interdisciplinary care and collaboration needed for these individuals. The JAHVH is also a Polytrauma Network site which encompasses an outpatient system of care for this special population which will transcend all points across a continuum of primary through tertiary care.
The JAHVH has been selected as a pilot site for the National VA RN Residency Program. This national program is in conjunction with the VA Nursing Academy and Office of Nursing Services. The RN Residency Program will consist of a 12 month plan to orient, support, and mentor graduate nurses. This program illustrates another example of the JAHVH's commitment toward providing RNs with vehicles to grow professional and personally and will serve as a strong recruitment tool.
Transforming Care At the Bedside (TCAB) is funded by the Robert Wood Johnson Foundation and managed by IHI with the aim of developing new models of patient centered care that improve patient safety and reliability and foster staff vitality and teamwork. This TCAB project's major characteristics are being successfully implemented throughout our facility and promote professional practice in a fully interprofessional environment.
The Evidence Based Nursing Practice Fellowship at JAHVH is a program for the experienced registered nurse who desires to transfer and expand knowledge and skills in Evidence-based Nursing Practice and generate a change in practice to improve patient outcomes and organizational systems.
The JAHVH is also headquarters to the Veterans Integrated Service Network 8 (VISN 8) Patient Safety Center of Inquiry (PSC). The PSC has been partially funded since 1999 by the VA National Center for Patient Safety and VA Rehabilitation Research and Development (RR&D). The PSC focuses on preventing adverse events associated with mobility and immobility in frail older adults and persons with disabilities, particularly patient falls, safe patient handling, hospital bed/wheelchair safety, wandering, and pressure ulcers. Additional research activities focus on Polytrauma, such as examination of the taxonomy of blast injuries and development of a health-related quality of life instrument for individuals with deployment-related traumatic brain injury.
The JAHVH and CON Collaborative has resulted in more than one third of graduating seniors pursuing employment in the JAHVH. New graduates who have trained at the JAHVH are able to transition from the hospital orientation program into the staff nurse role more quickly than graduates from other nursing programs. It is estimated that the orientation time is decreased by approximately 50% for students who graduated from the CON and had their clinical rotations at the JAHVH (conversation with JAHVH Human Resources). This translates into more nurses working on the units, providing care to the patients and support to the existing personnel as a result of the unique nature of the relationship through the Burn's Model. This mutually beneficial relationship between the JAHVH and the CON has resulted in many JAHVH nurses receiving their BS and advanced practice degrees.
The first aim of the VANA is to increase JAHVH recruitment and retention of baccalaureate prepared registered nurses through enhanced clinical and curriculum experiences. This aim is targeted through the new, enhanced and innovative educational opportunities (Opportunities) through the VANA. Innovative Educational Opportunities. The overarching objectives of the Opportunities are patient safety and continuum of care. These opportunities will be provided to VANA students in both the traditional and accelerated programs of study. These programs have differing numbers of semesters and didactic and clinical course distributions. As such, the Opportunities are contextualized through a conceptual learning framework of foundational, specialized and theoretical cognates as opposed to semesters, which provides for implementation of the Opportunities across both programs. Each cognate correlates with CON program didactic course components and includes Patient Safety in the Foundational Cognate Patient Safety and Interprofessional Care on Polytrauma: Specialty Cognate Patient Safety Research in Nursing Inquiry: Theoretical Cognate, Community Systems in Polytrauma in Theoretical Cognate Evidence Based Nursing Principles in Nursing Leadership: Theoretical Cognate Preceptorship: Theoretical Cognate. New, enhanced, and innovative curriculum components include the PDA initiative and Patient Simulation Experiences.
The second aim of the VANA is expansion of faculty. Potential faculty are solicited through the use of an interest survey, distributed at various JAHVH Advanced Practice Council meetings. Response and interest levels were high.
The third aim of the VANA is the provision of a continuum of education for the VANA faculty. The faculty development program at the College of Nursing is well prepared to provide scheduled, ongoing opportunities for the development of knowledge, teaching roles and competencies as clinically based advanced nurses participate in teaching opportunities. Many JAHVH Advanced Nurse Practitioners and Clinical Nurse Specialists have had some exposure and training on preceptor role with students and of the current identified JAHVH faculty; one is already a Hospital Based faculty and two have precepted CON undergraduate students. The JAHVH Faculty performed a self assessment with respect to their perceived level of competency as educators and designated opportunities of interest to further develop skill sets as educators. Interest in an opportunity for earning credits toward a Graduate Certificate in Nursing Education or Certification in Nursing Education were explored with all but one participant indicating moderate to high interest in attaining these certifications.
Benefits to the JAHVH through this collaborative with the development of the VANA will resonate throughout the organization. The development of enhanced core competencies in the JAHVH Faculty as educators and the enrichment of their knowledge base and educational acumen will in turn contribute to the professional development of the nursing staff of the JAHVH. This is realized through the implementation of innovative educational practices. The relationship between the JAHVH and the CON through the VANA will produce graduate nurses who bring to the organization the benefits of enhanced competency, clinical skill sets, and a commitment to the mission and vision of the JAHVH.