Nurse Residency Program: Best Practices for Optimizing Organizational Success

A nurse residency program’s best practice recommendations are presented within this article and are organized around three processes: establishing the program infrastructure, creating a multistaged evidence-based program, and sustaining the program through appropriate evaluation and dissemination of results. These recommendations represent lessons learned and key findings derived from a team of academic and nursing professional development educators after 7 years of residency program implementation at multiple rural and urban hospital sites. Organizations, regardless of size and resources, can use these recommendations to increase the likelihood of building a successful residency program

Implementing an MSN Nursing Program at a Distance Through an Urban-Rural Partnership

Recruiting, retaining, and educating advanced practice nurses is essential to meet the growing need for advanced practice nurses in rural and urban communities. Through the support of Health Resources and Services Administration funding, the urban school of nursing expanded its MSN program and implemented the graduate curriculum on its rural campus by utilizing emerging online and distance education technologies. The purpose of this manuscript is to provide an overview of expanding an existing MSN program offered in an urban, traditional classroom setting to rural graduate nursing students via an online synchronous format. In addition, the article will describe the rural growth of the existing neonatal nurse practitioner program as an exemplar and the different methodologies that are being used in each program to engage the rural nurse practitioner students in clinical courses. In addition, strategies to address barriers related to rural nurse practitioner student recruitment and retention will be discussed

Implementing a Practice Doctorate Program at a Distance through an Urban-Rural Partnership

The purposes of this poster presentation are to 1) describe the implementation of a doctor of nursing practice (DNP) program by providing access to rigorous distance education to students living in rural Pennsylvania; 2) discuss building a critical mass of doctorally prepared advanced practice nurse experts in both urban and rural communities; and 3) share formative and summative evaluation information. Through funding from the U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions, Division of Nursing, the Jefferson School of Nursing (JSN) expanded its DNP program currently offered at the urban Philadelphia campus to the rural campus in Danville. Using the methodologies of live web-casting and live video over the Internet, distance students are afforded the opportunity to participate in a live classroom setting rather than experience the static distance methodology of reading through lectures themselves. For example, during the applied biostatistics course, the faculty teaches onsite in Philadelphia projecting the SPSS and the database on screen so that students on both campuses can simultaneously view, hear, and interact with the discussion. There is a doctorally prepared faculty member onsite in Danville as a resource for the students. These newer technologies make possible real-time faculty-student dialogue, student-to-student dialogue, and enhance socialization. Furthermore, the use of advanced technologies allows distance students to discuss with peers and faculty alike, in real time, the problems, successes, and questions which arise during class and clinical practica, thereby enhancing critical thinking and diagnostic reasoning skills. This unique urban-rural partnership, made possible through advanced technologies, addresses increasing demands for educating greater numbers of doctorally prepared advanced practice nurses to work in north and central rural Pennsylvania, thus promoting access to health care in rural underserved communities. Other than in academia, there are no doctorally prepared advanced practice nurses employed in practice in the area

Implementing a graduate nursing program at a distance through an urban-rural partnership.

The purposes of this poster presentation are to 1) describe the implementation of a master’s of science in nursing (MSN) program by providing access to rigorous distance education to students living in rural Pennsylvania; 2) discuss building a critical mass of master’s prepared advanced practice nurse experts in rural communities; and 3) share formative and summative evaluation information. Through funding from the U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions, Division of Nursing, the Jefferson School of Nursing (JSN) expanded its MSN program currently offered at the urban Philadelphia campus to the rural campus in Danville. Using the methodologies of live web-casting and live video over the Internet, distance students are afforded the opportunity to participate in a live classroom setting rather than experience the static distance methodology of reading through lectures themselves. For example, during the clinical courses, the faculty teaches onsite in Philadelphia webcasting to students in their rural homes so that they can view and hear the lecture. These newer technologies make possible real-time faculty-student dialogue, student-to-student dialogue, and enhance socialization. Furthermore, the use of advanced technologies allows distance students to discuss with peers and faculty alike, in real time, the problems, successes, and questions which arise during class and clinical practica, thereby enhancing critical thinking and diagnostic reasoning skills. This urban-rural partnership addresses increasing demands for educating greater numbers of master’s prepared advanced practice nurses to work in north and central rural Pennsylvania thus promoting access to health care in rural underserved communities

Cultural matter in the development of an interactive multimedia self-paced educational health program for aboriginal health workers

Aboriginal and Torres Strait islander health workers are key providers of primary health services to Aboriginal communities especially in remote and rural areas. They are often overloaded with competing demands. There has been limited attention given to the maintenance and ongoing enhancement of their skills and knowledge following the completion of formal training. A culturally appropriated interactive multimedia self-paced health program as a mechanism to improve the accessibility and the use of scientific data and information for health purposes is proposed as a basic method for better supporting Aboriginal and Torres Strait Islander primary health care workers in their practice locations. This paper explores different approaches for the development of a culturally appropriate interactive multimedia educational health program for Aboriginal and Torres Strait islander health workers and it also explore cultural matters concerning program development in the light of existing literature

Does Exam-targeted Training Help Village Doctors Pass the Certified (Assistant) Physician Exam and Improve Their Practical Skills? A Cross-sectional Analysis of Village Doctors\u27 Perspectives in Changzhou in Eastern China

Background Quality of health care needs to be improved in rural China. The Chinese government, based on the 1999 Law on Physicians, started implementing the Rural Doctor Practice Regulation in 2004 to increase the percentage of certified physicians among village doctors. Special exam-targeted training for rural doctors therefore was launched as a national initiative. This study examined these rural doctors’ perceptions of whether that training helps them pass the exam and whether it improves their skills. Methods Three counties were selected from the 4 counties in Changzhou City in eastern China, and 844 village doctors were surveyed by a questionnaire in July 2012. Chi-square test and Fisher exact test were used to identify differences of attitudes about the exam and training between the rural doctors and certified (assistant) doctors. Longitudinal annual statistics (1980–2014) of village doctors were further analyzed. Results Eight hundred and forty-four village doctors were asked to participate, and 837 (99.17%) responded. Only 14.93% of the respondents had received physician (assistant) certification. Only 49.45% of the village doctors thought that the areas tested by the certification exam were closely related to the healthcare needs of rural populations. The majority (86.19%) felt that the training program was “very helpful” or “helpful” for preparing for the exam. More than half the village doctors (61.46%) attended the “weekly school”. The village doctors considered the most effective method of learning was “continuous training (40.36%)” . The majority of the rural doctors (89.91%) said they would be willing to participate in the training and 96.87% stated that they could afford to pay up to 2000 yuan for it. Conclusions The majority of village doctors in Changzhou City perceived that neither the certification exam nor the training for it are closely related to the actual healthcare needs of rural residents. Policies and programs should focus on providing exam-preparation training for selected rural doctors, reducing training expenditures, and utilizing web-based methods. The training focused on rural practice should be provided to all village doctors, even certified physicians. The government should also adjust the local licensing requirements to attract and recruit new village doctors

Train the trainer model : implications for health professionals and farm family health in Australia

Australia is a large country with 60% of land used for agricultural production. Its interior is sparsely populated, with higher morbidity and mortality recorded in rural areas, particularly farmers, farm families, and agricultural workers. Rural health professionals in addressing health education gaps of farming groups have reported using behavioralist approaches. These approaches in isolation have been criticized as disempowering for participants who are identified as passive learners or \u27empty vessels.\u27 A major challenge in rural health practice is to develop more inclusive and innovative models in building improved health outcomes. The Sustainable Farm Families Train the Trainer (SFFTTT) model is a 5-day program developed by Western District Health Service designed to enhance practice among health professionals working with farm families in Australia. This innovative model of addressing farmer health asks health professionals to understand the context of the farm family and encourages them to value the experience and existing knowledge of the farmer, the family and the farm business. The SFFTTT program has engaged with health agencies, community, government, and industry groups across Australia and over 120 rural nurses have been trained since 2005. These trainers have successfully delivered programs to 1000 farm families, with high participant completion, positive evaluation, and improved health indicators. Rural professionals report changes in how they approach health education, clinical practice, and promotion with farm families and agricultural industries. This paper highlights the success of SFFTTT as an effective tool in enhancing primary health practice in rural and remote settings. The program is benefiting not only drought ravaged farmers but assisting rural nurses, health agencies, and health boards to engage with farm families at a level not identified previously. Furthermore, nurses and health professionals are now embracing a more \u27farmer-centered model of care.\u27 <br /

An Approach to Monitor and Initiate Community Led Actions for Antenatal Care in Rural India – A Pilot Study

Background and Objective: Utilization of antenatal care in rural India is far from universal. It requires monitoring and identification of specific needs at field level for timely corrective actions. To pilot test the triangulation of rapid quantitative (Lot Quality Assurance Sampling) and qualitative (Focus Group Discussion) monitoring tools for ensuring antenatal care in a community based program. Methods: The present study was undertaken in surrounding 23 villages of Kasturba Rural Health Training Centre (KRHTC), Anji, which is also a field practice area of Mahatma Gandhi Institute of Medical Sciences (MGIMS), Sewagram. The monthly monitoring and action system of the study was based on the rapid quantitative monitoring tool (Lot Quality Assurance Sampling, LQAS)to find out poor performing supervision areas and overall antenatal service coverage and the qualitative methods (Focus group discussions (FGDs), and free listing) for exploring ongoing operational constraints in the processes for timely decision making at program and community level. A trained program supervisor paid house visit to 95 randomly selected pregnant women from 5 supervision areas by using pre-designed and pre-tested questionnaire. For poor performing indicators, semi structured FGDs and free listing exercise were undertaken to identify unmet service needs and reasons for its poor performance. Results: Registration of pregnancy within 12 weeks improved from 22.8% to 29.6%. The consumption of 100 or more IFA tablets during pregnancy significantly improved from 6.3% to 17.3%. There was significant improvement in awareness among pregnant women regarding danger signs and symptoms during pregnancy. Over three months period, the overall antenatal registration improved from 253 (67%) to 327 (86.7%). Conclusion: The present field based monitoring and action approach constructively identified the reasons for failures and directed specific collective actions to achieve the targets

Developing clinical decision tools to implement chronic disease prevention and screening in primary care: the BETTER 2 program (building on existing tools to improve chronic disease prevention and screening in primary care).

BackgroundThe Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Family Practice (BETTER) trial demonstrated the effectiveness of an approach to chronic disease prevention and screening (CDPS) through a new skilled role of a 'prevention practitioner'(PP). The PP has appointments with patients 40-65 years of age that focus on primary prevention activities and screening of cancer (breast, colorectal, cervical), diabetes and cardiovascular disease and associated lifestyle factors. There are numerous and occasionally conflicting evidence-based guidelines for CDPS, and the majority of these guidelines are focused on specific diseases or conditions; however, primary care providers often attend to patients with multiple conditions. To ensure that high-level evidence guidelines were used, existing clinical practice guidelines and tools were reviewed and integrated into blended BETTER tool kits. Building on the results of the BETTER trial, the BETTER tools were updated for implementation of the BETTER 2 program into participating urban, rural and remote communities across Canada.MethodsA clinical working group consisting of PPs, clinicians and researchers with support from the Centre for Effective Practice reviewed the literature to update, revise and adapt the integrated evidence algorithms and tool kits used in the BETTER trial. These resources are nuanced, based on individual patient risk, values and preferences and are designed to facilitate decision-making between providers across the target diseases and lifestyle factors included in the BETTER 2 program. Using the updated BETTER 2 toolkit, clinicians 1) determine which CDPS actions patients are eligible to receive and 2) develop individualized 'prevention prescriptions' with patients through shared decision-making and motivational interviewing.ResultsThe tools identify the patients' risks and eligible primary CDPS activities: the patient survey captures the patient's health history; the prevention visit form and integrated CDPS care map identify eligible CDPS activities and facilitate decisions when certain conditions are met; and the 'bubble diagram' and 'prevention prescription' promote shared decision-making.ConclusionThe integrated clinical decision-making tools of BETTER 2 provide resources for clinicians and policymakers that address patients' complex care needs beyond single disease approaches and can be adapted to facilitate CDPS in the urban, rural and remote clinical setting.Trial registrationThe registration number of the original RCT BETTER trial was ISRCTN07170460