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Faculty improve clinical operations
T
HE ECONOMIC CRISIS confronting this country has not overlooked schools of nursing within senior colleges and universities nor health care organizations where students learn. As both of these groups are streamlining, reorganizing, and developing frugal strategic plans, they should examine each other to determine if a more formal unification of nursing education and practice would provide a means for achieving mutual success. Rush University College of Nursing and the hospitals at the Medical Center have a working unification model. The faculty, called practitioner/teachers (P/T), have part-time budgeted positions on clinical units in their areas of expertise. What does the college gain from this unification model? The monetary benefit of funding part of a faculty salary is helpful to a college that must operate with revenues (tuition, capitation, Medicare pass-through) meeting expenses (salaries and operations). Beyond that, however, the P/T remains updated in clinical practice, maintains the credibility of a practicing faculty member in a service profession, and makes substantive contributions to the clinical setting that improves patient care. What is the return on this investment in the hospital setting? P/Ts improve clinical operations in their roles across six areas: (1) patient care, (2) consultation and patient education, (3) committee membership, (4) staff development, (5) clinical management, and (6) clinical research. Patient care: P/Ts provide indirect patient care 40 out of 52 weeks while supervising undergraduate students. Moreover, the P/T is the quality check on the student’s performance and serves as the quality facilitator of the care plan. P/Ts provide direct patient care, as arranged with unit leadership, during quarter breaks, on some holidays, and during nursing shortage periods. They also participate in patient clinical conferences during which team decisions are made about patient care. Consultation and patient education: P/Ts consult with staff nurses and physicians in their area of expertise, and these consultations result in an improved plan of patient care. Examples of patients who have profited are those with physical restraints, skin problems, Alzheimer’s disease, incontinence, undue pain, liver transplantation, mobility problems, family crises, ethical decision-making issues, acquired immunodeficiency syndrome complications, etc. P/Ts have helped patients help themselves through self-care instruction such as lactation education for breastfeeding mothers, pain management in cancer patients, enterostomy therapy, discharge teaching, group therapy, car-
KATHLEEN
G. ANDREOLI, DSN
Vice President Nursing Aflairs Dean of the CoIlege of Nursing Rush-Presbyterian-St. Luke’s Medic& Center Chiurgo, IL 60612
Copyright 0 1993 by W.B. Saunders Company
8755-7223/93/0904-0004$03.00/O Jolcmal
of PmfesJional
disc rehabilitation, ventilation home care, bereavement and so on. P/Ts have also prepared patient information booklets on open heart surgery, outpatient surgery, infant care, and many other topics. In the area of unit management P/Ts have contributed to the development of a new patientcentered model of care with associated technology and reorganization. With physicians, PITS are creating clinical pathways, which are valuable tools for decreasing length of stay, decreasing costs, and improving quality of care. Committee membership: P/Ts are active on nursing and hospitalwide committees required by the Joint Commission on the Accreditation of Health Care Organizations and the State Department of Public Health. P/T leadership and membership are noted on standing committees: documentation, infectious disease and sepsis control, standards of practice, and nursing care evaluation. The total quality management projects that have emerged from the work of the latter committee have received national recognition. Other committees include disaster, education programs, nursing recognition, and promotions and public relations. Hospitalwide committee participation includes new products, chapel planning, discharge planning and utilization, employee of the quarter and year, pharmacy and therapeutics, chairperson search committees, hospital medical records, and the like. Staff development: P/Ts direct and contribute to educational programs for new staff and for continuing staff. Programs include preceptor workshops, critical care courses, advanced cardiac life support, basic and advanced cardiac arrhythmias, oncology chemotherapy series, advanced directives, etc. They also plan and participate in annual symposia and assist the hospital Office of Professional Develop ment, which is minimally staffed with two professionals. Clinical management: P/Ts work closely with unit leadership in staff meetings, chart audits, nursing care plan review, quality monitoring, new staff orientation, and staff performance appraisals. In the absence of unit leadership P/Ts assist with administrative duties. Clinical research: P/T studies that have improved patient care at Rush include skin assessment and prevention of pressure sores, reducing aspiration on a ventilator, identifying nutritional alterations with human immunodeficiency virus infection, assessing and managing cognitive impairments in hospitalized elderly, managing pain in children with cancer, interventions with cocaine-abusing mothers, and so on. Of particular importance is the testing of the new patient-centered model of care characterized by decentralization of services, levels of nursing managers and caregivers, multitask workers, conservation of resources, communication and documentation technology, quality improvement, manager and staff development, and salary compensation and evaluation. In conclusion, the foregoing productivity report justifies faculty as members of clinical teams. The return on investment far outweighs the cost, and both parties benefit. Nursing,
Vol 9, No 4 CJuly-August),
1993: p 194
HE ECONOMIC CRISIS confronting this country has not overlooked schools of nursing within senior colleges and universities nor health care organizations where students learn. As both of these groups are streamlining, reorganizing, and developing frugal strategic plans, they should examine each other to determine if a more formal unification of nursing education and practice would provide a means for achieving mutual success. Rush University College of Nursing and the hospitals at the Medical Center have a working unification model. The faculty, called practitioner/teachers (P/T), have part-time budgeted positions on clinical units in their areas of expertise. What does the college gain from this unification model? The monetary benefit of funding part of a faculty salary is helpful to a college that must operate with revenues (tuition, capitation, Medicare pass-through) meeting expenses (salaries and operations). Beyond that, however, the P/T remains updated in clinical practice, maintains the credibility of a practicing faculty member in a service profession, and makes substantive contributions to the clinical setting that improves patient care. What is the return on this investment in the hospital setting? P/Ts improve clinical operations in their roles across six areas: (1) patient care, (2) consultation and patient education, (3) committee membership, (4) staff development, (5) clinical management, and (6) clinical research. Patient care: P/Ts provide indirect patient care 40 out of 52 weeks while supervising undergraduate students. Moreover, the P/T is the quality check on the student’s performance and serves as the quality facilitator of the care plan. P/Ts provide direct patient care, as arranged with unit leadership, during quarter breaks, on some holidays, and during nursing shortage periods. They also participate in patient clinical conferences during which team decisions are made about patient care. Consultation and patient education: P/Ts consult with staff nurses and physicians in their area of expertise, and these consultations result in an improved plan of patient care. Examples of patients who have profited are those with physical restraints, skin problems, Alzheimer’s disease, incontinence, undue pain, liver transplantation, mobility problems, family crises, ethical decision-making issues, acquired immunodeficiency syndrome complications, etc. P/Ts have helped patients help themselves through self-care instruction such as lactation education for breastfeeding mothers, pain management in cancer patients, enterostomy therapy, discharge teaching, group therapy, car-
KATHLEEN
G. ANDREOLI, DSN
Vice President Nursing Aflairs Dean of the CoIlege of Nursing Rush-Presbyterian-St. Luke’s Medic& Center Chiurgo, IL 60612
Copyright 0 1993 by W.B. Saunders Company
8755-7223/93/0904-0004$03.00/O Jolcmal
of PmfesJional
disc rehabilitation, ventilation home care, bereavement and so on. P/Ts have also prepared patient information booklets on open heart surgery, outpatient surgery, infant care, and many other topics. In the area of unit management P/Ts have contributed to the development of a new patientcentered model of care with associated technology and reorganization. With physicians, PITS are creating clinical pathways, which are valuable tools for decreasing length of stay, decreasing costs, and improving quality of care. Committee membership: P/Ts are active on nursing and hospitalwide committees required by the Joint Commission on the Accreditation of Health Care Organizations and the State Department of Public Health. P/T leadership and membership are noted on standing committees: documentation, infectious disease and sepsis control, standards of practice, and nursing care evaluation. The total quality management projects that have emerged from the work of the latter committee have received national recognition. Other committees include disaster, education programs, nursing recognition, and promotions and public relations. Hospitalwide committee participation includes new products, chapel planning, discharge planning and utilization, employee of the quarter and year, pharmacy and therapeutics, chairperson search committees, hospital medical records, and the like. Staff development: P/Ts direct and contribute to educational programs for new staff and for continuing staff. Programs include preceptor workshops, critical care courses, advanced cardiac life support, basic and advanced cardiac arrhythmias, oncology chemotherapy series, advanced directives, etc. They also plan and participate in annual symposia and assist the hospital Office of Professional Develop ment, which is minimally staffed with two professionals. Clinical management: P/Ts work closely with unit leadership in staff meetings, chart audits, nursing care plan review, quality monitoring, new staff orientation, and staff performance appraisals. In the absence of unit leadership P/Ts assist with administrative duties. Clinical research: P/T studies that have improved patient care at Rush include skin assessment and prevention of pressure sores, reducing aspiration on a ventilator, identifying nutritional alterations with human immunodeficiency virus infection, assessing and managing cognitive impairments in hospitalized elderly, managing pain in children with cancer, interventions with cocaine-abusing mothers, and so on. Of particular importance is the testing of the new patient-centered model of care characterized by decentralization of services, levels of nursing managers and caregivers, multitask workers, conservation of resources, communication and documentation technology, quality improvement, manager and staff development, and salary compensation and evaluation. In conclusion, the foregoing productivity report justifies faculty as members of clinical teams. The return on investment far outweighs the cost, and both parties benefit. Nursing,
Vol 9, No 4 CJuly-August),
1993: p 194