Marcia Pencak Murphy

Nurse practitioner education: greater demand, reduced training opportunities.

Purpose: To document the factors that are increasing the tension between nurse practitioner (NP) educational programs and the clinical training sites needed for NP students. Data sources: Literature and the faculty experiences garnered over years of placing NP students for clinical training. Conclusions: Several conditions converge to create a situation where sites are increasingly reluctant to precept NP students. The underlying dynamics are diverse and include factors related to the electronic health record, productivity expectations, and the increasing demand for sites as a result of increasing NP enrollments and competing healthcare provider programs. Implications for practice: The nursing community should approach this issue strategically and devise an action and policy agenda to support NP training, including federal monies to support NP training in a design that parallels the Graduate Medical Education; recognition of NPs as licensed professionals in advanced training; and identification of meaningful incentives for NP preceptors.

Collaboration Among DNP- and PhD-Prepared Nurses: Opportunity to Drive Positive Change

Because of the rapidly changing environment of doctoral education, collaborative relationships between doctor of nursing practice and doctor of philosophy-prepared nurses continue to evolve. Although there are few currently reportable outcomes, examples are given of collaborative efforts highlighting scholarship, education, practice, and research. In accordance with the Institute Of Medicine recommendations and building upon work done by the American Association of Colleges of Nursing, this article describes opportunities for expanding collaboration among doctoral-prepared nurses. Collaboration facilitates a timely translation of research into practice, enhances educational opportunities, drives positive change, and improves health outcomes.

Improving cardiovascular health of underserved populations in the community with Life's Simple 7

Purpose:The purpose of this nurse practitioner (NP) led initiative was to improve the cardiovascular health of two underserved populations in the community using the American Heart Association (AHA) Lifes Simple 7 and My Life Check (MLC) tools. Data sources:Two inner city community sites were targeted: (a) a senior center servicing African American (AA) older adults, and (b) a residential facility servicing homeless women. Preprogram health data (blood pressure, cholesterol, blood glucose levels, body mass index, and health behaviors) were collected to calculate MLC scores. Postprogram health data were obtained on participants with the lowest MLC scores who completed the program. Conclusions:Eight older adults completed the program with a 37.1% increase in average MLC score (6.2 vs. 8.5). Ten women completed the program with a 9.3% decrease in average MLC score (4.3 vs. 3.9). Favorable benefits were observed in the AA older adults. In contrast, similar benefits were not observed in the women, which may be because of a constellation of social, environmental, biological, and mental health factors. Implications for practice:NPs are prepared to target community‐based settings to address the health of underserved populations. Engaging key stakeholders in the planning and implementation is essential for success.

Collaborative practice in advanced practice nursing in acute care.

APN in the United States encompasses a variety of collaborative models of care. Collaborative relationships with other disciplines such as medicine, pharmacy, social service, and physical, respiratory, and occupational therapy are an important component of the APN role. The collaborative relationship of the APN and physician is a unique one for providing optimal patient and family care. As changes in healthcare in acute care settings continue to occur, additional collaborative models for APN and physician care will only continue to help in meeting the healthcare needs of patients.

Overcoming the Tension: Building Effective DNP-PhD Faculty Teams

A shift in terminal degrees held by nursing faculty is occurring as the number of doctor of nursing practice graduates continues to rise. This change has resulted in some uncertainty and tension. At the same time, there is a pressing need for collaboration among doctoral-prepared nurse leaders to improve care and outcomes for the population. An intellectual community that nurtures learning for all members serves as a blueprint for moving toward a professoriate that engages both doctor of nursing practice- and doctor of philosophy-prepared faculty and enhances scholarly activities, research, and teaching productivity. Although this may seem like an intangible concept, strategic steps can be instituted to promote positive relationships and transform the academic culture into an environment that fosters a vibrant intellectual life for all faculty members. Therefore, the purpose of this article is to propose that doctoral faculty embrace a transformational change to promote a community of scholars who serve as stewards of the discipline. Specific strategies for transforming the culture and building an intellectual community are described.

Integrating gerontological content across advanced practice registered nurse programs

Purpose Faculty members across the country are faced with integrating gerontological content and competencies across advanced practice registered nurse (APRN) programs that focus on the adult-gerontology population. The purpose of this initiative was to effectively and efficiently integrate gerontological content into the adult management courses for several APRN programs in acute and primary care at one universitys college of nursing. Data sources Current literature, resources for integrating adult-gerontology content, course evaluations, and end of program surveys were used in this project. Conclusion This curricular update effectively utilized resources and engaged faculty across programs to infuse gerontological content into the adult management courses. Students from multiple programs sharing these courses benefited from gerontological lecturers, content, and learning activities. The content gaps were integrated into existing courses rather than developing a new course. Current outcome data reflect this was an effective curricular change. Implications for practice In conjunction with meeting national requirements for integrating adult-gerontology content into APRN curriculum, APRNs prepared with enhanced gerontological knowledge and skills build a workforce that is competent to improve care for older adults across the continuum of care.Purpose: Faculty members across the country are faced with integrating gerontological content and competencies across advanced practice registered nurse (APRN) programs that focus on the adult‐gerontology population. The purpose of this initiative was to effectively and efficiently integrate gerontological content into the adult management courses for several APRN programs in acute and primary care at one universitys college of nursing. Data sources: Current literature, resources for integrating adult‐gerontology content, course evaluations, and end of program surveys were used in this project. Conclusion: This curricular update effectively utilized resources and engaged faculty across programs to infuse gerontological content into the adult management courses. Students from multiple programs sharing these courses benefited from gerontological lecturers, content, and learning activities. The content gaps were integrated into existing courses rather than developing a new course. Current outcome data reflect this was an effective curricular change. Implications for practice: In conjunction with meeting national requirements for integrating adult‐gerontology content into APRN curriculum, APRNs prepared with enhanced gerontological knowledge and skills build a workforce that is competent to improve care for older adults across the continuum of care.

Advanced practice nursing students in the patient-centered medical home: preparing for a new reality.

Driven by reimbursement incentives for increased access, improved quality and reduced cost, the patient-centered medical home model of health care delivery is being adopted in primary care practices across the nation. The transition from traditional primary care models to patient-centered medical homes presents many challenges, including the assembly of a well-prepared, interprofessional provider team to achieve effective, well-coordinated care. In turn, advanced practice nursing education programs are challenged to prepare graduates who are qualified for practice in the new reality of health care reform. This article reviews the patient-centered medical home model and describes how one college of nursing joined 7 primary care physician practices to prepare advanced practice nursing students for the new realities of health care reform while supporting each practice in its transition to the patient-centered medical home.

Promoting Professional Nursing Practice: Linking a Professional Practice Model to Performance Expectations

Professional practice models (PPMs) provide the conceptual framework for establishing professional nursing practice. Integrating a PPM requires complex organizational change. One strategy for integrating a PPM is to directly link the PPM with performance expectations to ensure that underlying beliefs are integrated into everyday practice. This article describes the development, implementation, and successful outcomes of a clinical advancement system that was aligned with a PPM.

Determinants for effective collaboration among DNP- and PhD-prepared faculty

BACKGROUND Uncertainty exists surrounding collaborative relations among Doctor of Nursing Practice (DNP)- and Doctor of Philosophy (PhD)-prepared faculty. PURPOSE This qualitative study explored the attitudes and determinants for effective collaboration among doctoral-prepared nursing faculty. METHODS Focus groups were conducted using a convenience sample of doctoral faculty who taught in either/both DNP or PhD programs. Focus group questions were derived to identify interpersonal, organizational, and systemic determinants of collaboration. Data were transcribed and content analyzed using Kruger and Casey methods. RESULTS Four focus groups included 41 faculty members from two metro area university medical centers. Five themes emerged: (a) DNP not well understood, (b) confusion surrounding research, (c) opportunities for collaboration, (d) lack of structural support, and (e) personal characteristics and attitudes. DISCUSSION Interpersonal relationships, organizational structures, and systemic impacts have both positive and negative influences on successful collaboration among DNP- and PhD-prepared faculty. CONCLUSION Collaborative efforts are needed for advancing the profession.

Promoting DNP-PhD collaboration in doctoral education: Forming a DNP project team

As the Doctor of Nursing Practice (DNP) degree continues to evolve, challenges exist with the scholarly project. The American Association of Colleges of Nursing (AACN) has set forth guidelines for the DNP project (2015), however, at this point there is variation with respect to the structure of the DNP project team. This is particularly important given the: 1) growing number of DNP students; 2) need to foster scholarship; and 3) necessity for ensuring rigor of this degree (Waldrop, Caruso, Fuchs & Hypes, 2014). An opportunity exists to establish a project team that promotes scholarly formation, collaboration, and efficiency. Therefore, this paper describes purposefully pairing DNP-Doctor of Philosophy (PhD) faculty as part of the DNP project team. Collaboration among DNP-PhD-prepared faculty guides DNP student formation and fosters a community of scholars, yet little has been reported specifically addressing the pairing of DNP-PhD faculty on DNP student projects. Benefits of this collaborative approach are presented and may be helpful for other colleges of nursing.